金黄色葡萄球菌致晚期肺癌患者下呼吸道感染的临床与耐药性分析  

Resistance of Staphylococcus aureus in advanced lung cancer patients with lower respiratory tract infection

作　　者：王小娟[1] 陈俊华 王惠姣[1] 

机构地区：[1]金华市人民医院检验科,浙江金华321000 [2]金华市文荣医院检验科,浙江金华321001

出　　处：《中国微生态学杂志》2015年第10期1202-1205,共4页Chinese Journal of Microecology

摘　　要：目的了解金黄色葡萄球菌（SA）致晚期肺癌患者下呼吸道感染的临床与耐药特征,为临床合理用药提供参考依据。方法收集金华市人民医院2009年12月至2014年11月住院治疗晚期肺癌患者发生下呼吸道感染的送检标本,应用法国生物梅里埃Vitek 2-Compact全自动微生物鉴定仪鉴定菌种,药敏试验采用纸片法（K-B）进行。结果157株SA中耐甲氧西林金黄色葡萄球菌（MRSA）98株,占62.4%,药敏试验表明MRSA对青霉素G、红霉素、四环素、头孢西丁、莫西沙星100.0%耐药,对β-内酰胺类、喹诺酮类、大环内酯类、氨基糖苷类、磺胺类抗菌药物耐药率均较高（26.5%~93.9%）,且存在多药耐药,MRSA耐药率普遍高于MSSA,差异有统计学意义（P〈0.05）。结论从晚期肺癌患者合并下呼吸道感染患者中分离出的金黄色葡萄球菌以MRSA为主,MRSA较MSSA的耐药性高,而且多重耐药严重,临床必须加强金黄色葡萄球菌感染的监控,并根据药敏试验结果合理选用抗菌药物。Objective To learn the clinical characteristics and resistance of Staphylococcus aureus （SA） from lower respiratory tract infections in patients with advanced lung cancer, and provide reference for rational use of drugs. Methods Clinical specimens of advanced lung cancer patients with lower respiratory tract infec- tions admitted in Zhejiang Jinhua People＇s Hospital from December 2009 to November 2014 were collected. BioMerieux Vitek 2-Compact was used to identify the bacteria. Drug susceptibility was tested by using disk method （K-B）. Results In the total of 157 strains of SA, 98 strains （62.4%） were methicillin-resistant Staphylococcus aureus （MRSA）. The resistance rates of the MRSA strains were 100.0% to Penicillin G, E- rythromycin, Tetracycline, Cefoxitin and Moxifloxacin, while those to β-1actams, Quinolones, Macrolides, Aminoglycosides and Sulfonamides ranged between 26, 5 % and 93.9%. There were multi-drug resistant MR- SAs with the resistance rate significantly higher than that of MSSAs （P〈0. 05）. Conclusion MRSAs are the main pathogens isolated from advanced lung cancer patients with lower respiratory tract infections, which have higher re- sistance than MSSAs, and many are multi-drug resistant. The monitoring of Staphylococcus aureus infection should be enhanced, and drugs should be used rationally based on susceptibility test results.

关 键 词：金黄色葡萄球菌 晚期肺癌 下呼吸道感染 临床特征 耐药性 

分 类 号：R446.5[医药卫生—诊断学]