综合性医院金黄色葡萄球菌的分布及耐药性分析  

Distribution of Staphylococcus aureus in comprehensive hospital and its drug resistance

作　　者：尧荣凤[1] 李智[1] 薛龙[1] 徐龙[1] 许国祥[2] 

机构地区：[1]同济大学附属杨浦医院检验科,上海200090 [2]上海市第七人民医院康复科,上海200137

出　　处：《中国抗生素杂志》2015年第9期695-699,共5页Chinese Journal of Antibiotics

摘　　要：目的了解2009—2013年我院金黄色葡萄球菌临床分布及耐药性,为临床合理选用抗菌药物提供依据。方法对我院各类临床标本分离出的金黄色葡萄球菌的检出率、分布特点及药敏结果进行回顾性分析。结果 5年分离金黄色葡萄球菌主要来源于呼吸道标本,其次是血液标本,检出率分别为63.3%和15.5%;主要集中在ICU和急诊观察室,分别为25.7%和18.3%。金黄色葡萄球菌对β-内酰胺类、β-内酰胺酶抑制剂、大环内酯类、林可霉素类和第三代喹诺酮类等抗菌药物的耐药率均>50%,其中对青霉素G耐药率>94%。5年来金黄色葡萄球菌中MRSA的检出率为77.8%,MRSA对β-内酰胺类、β-内酰胺酶抑制剂、喹诺酮类、大环内酯类、氨基糖苷类、林可霉素类和四环素类抗生素的耐药率均要显著高于MSSA(P<0.05)。结论金黄色葡萄球菌感染可引起多部位感染,其中以上呼吸道为主,其对多种抗菌药物均可产生不同程度的耐药性,应规范临床用药,加强金黄色葡萄球菌耐药性监测,有效控制感染。Objective To provide the evidence for the rational use of antibiotics by investigating the distribution Staphylococcus aureus in our hospital from 2009 to 2013 and its drug resistance. Methods The detection rate, distribution characteristics and drug sensitivity test findings of Staphylococcus aureus isolated from a variety of clinical specimens were retrospectively analyzed. Results The detection rate of Staphylococcus aureus during the 5 years in respiratory samples was the highest followed by in blood specimens, with a detection rate of 63.3% and 15.5% respectively, among which 25.7% were from ICU, and 18.3% were from emergency observation room. The Staphylococcus aureus was more resistance against the β-1actams, β-Lactamaseinhibitors, macrolides, lincomycin and the third generation quinolone antibiotics, which the resistance rate all were higher than 50%. The resistance rate of Staphylococcus aureus to penicillin G was higher than 94%. During the 5 years, The average prevalence of methicillin-resistant strains in S. aureus（MRSA） was 77.8%, and MRSA against the β-1actams, β-Lactamaseinhibitors, quinolone, macrolides, aminoglycosides, lincomycin and tetracyclines antibiotics were significantly higher than methicilin-susceptible Staphylococcus aureus （MSSA） （P〈0.05）. Conclusion Highly drug resistant Staphylococcus aureus can cause infection in many other sites, especially in the upper respiratory tract. Antibiotics should be rationally used for Staphylococcus aureus infection and drug resistance of Staphylococcus aureus should be closely monitored in order to effectively control its infection.

关 键 词：金黄色葡萄球菌 分布 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]