综合性医院2011-2014年MRSA感染流行病学调查和耐药性分析  

Epidemiological survey and antibiotic resistance analysis of methicillin-resistant staphylococcus aureus in comprehensive hospitals from 2011 to 2014

作　　者：纵帅[1] 徐萍萍[2] 康海全[1] 冯倚帆 郝婷婷[1] 徐银海[1] 

机构地区：[1]徐州医学院附属医院检验科,江苏徐州221002 [2]徐州市中心医院检验科,江苏徐州221009

出　　处：《徐州医学院学报》2016年第3期191-194,共4页Acta Academiae Medicinae Xuzhou

基　　金：基金项目：徐州市科技项目（KC14SH116）

摘　　要：目的：回顾性分析耐甲氧西林金黄色葡萄球菌（ MRSA）医院感染的流行病学特征和耐药性特点。方法收集和统计2011—2014年徐州医学院附属医院MRSA感染的相关数据，分析其检出率、临床科室分布、标本来源和耐药性特点等。结果近4年MRSA的检出主要分布在ICU（含急诊ICU）、神经内科、神经外科、儿科和呼吸科等科室；检出标本中以痰液和血液为主，分别占61．3％和20．2％；对万古霉素、替考拉宁和利奈唑胺等100％敏感，对所选β－内酰胺类抗生素100％耐药，对其他抗生素耐药多在50％以上；万古霉素对MRSA的MIC＝2 mg／L的比例逐年增加。结论医院感染MRSA检出率高，呈严重的多重耐药特性，未发现耐万古霉素MRSA株；应加强对主要分布科室的监测和管理，防止菌株暴发流行；对MIC≥1．0 mg／L（肉汤稀释法）的MRSA感染患者应重点监控并积极进行抗生素治疗。Objective To retrospectively analyze the epidemiological characteristics and drug resistance of methicil-lin-resistant Staphylococcus aureus （ MRSA） which was isolated from nosocomial infection .Methods Clinical data a-bout MRSA infection in hospitals were collected from 2011 to 2014.Then, the detection rate, clinical distribution, sources of specimens and antibiotic resistance of MRSA were analyzed .Results The main departments where MRSA was detected were ICU （ including emergency ICU ） and Departments of Neurology , Neurosurgery , Pediatrics and Respiratory . MRSA infection was detected in 61.3%of sputum samples and 20.2%of blood samples.All MRSA strains were sensi-tive to vancomycin, linezolid, syncercid and teicoplanin, but resistant to the selected β-lactam antibiotics.More than 50%of the stains were resistant to other antibiotics .However , the ratio of MIC =2 mg/L of vancomycin to MRSA is gradually increased .Conclusion Hospital MRSA has a high infection rate and serious multiple antibiotic resistance , but no strain was resistant or intermediate to vancomycin .The monitoring and management to major distribution departments should be strengthened to prevent the outbreak .Patients with MRSA infection, whose MIC≥1.0 mg/L （broth microdilu-tion method）, should be given more intensive monitoring and active antibiotic therapy .

关 键 词：耐甲氧西林金黄色葡萄球菌 流行病学 耐药性 

分 类 号：R195.4[医药卫生—卫生统计学]