住院患者感染金黄色葡萄球菌分布与耐药性回顾性断面研究  

A retrospective study of distribution and drug resistance of Staphylococcus aureus in hospitalized patients

作　　者：杨莉莉[1] 王晓蕾[2] 刘华伟[1] 胡俊[2] 曹敏[1] 

机构地区：[1]成都市第三人民医院暨重庆医科大学附属成都第二临床学院检验科,四川成都610031 [2]成都市第三人民医院暨重庆医科大学附属成都第二临床学院儿科,四川成都610031

出　　处：《中华医院感染学杂志》2016年第19期4351-4353,共3页Chinese Journal of Nosocomiology

基　　金：国家自然基金资助项目(31500077);四川省科技厅应用基础研究基金资助项目(2013JY0121)

摘　　要：目的了解住院患者感染金黄色葡萄球菌(SAU)分布与耐药性,为深入研究金黄色葡萄球菌的致病性和耐药机制奠定基础。方法对2012年1月-2014年12月住院患者98 127份来自血液、胸腹水、尿液、感染灶分泌物/脓肿引流物、术后引流液、肺泡灌洗液(BALF)、鼻咽拭子和痰液等标本进行回顾性分析,分析感染SAU的分布及其对常用抗菌药物耐药趋势。结果 2012年1月-2014年12月住院患者共送检各类标本98 127份,标本检测阳性20 132份,阳性率20.52%;共检出率SAU 1 053株,检出率为5.23%;464株来源于合格下呼吸道标本,208株来源于感染灶分泌物/脓肿穿刺/引流物,60株来源于鼻咽拭子,分别占44.07%、19.75%、5.70%;SAU主要分布在呼吸科、儿科及ICU,分布率分别为17.19%、15.95%、11.30%;SAU对头孢曲松、氨苄西林/舒巴坦、四环素耐药率波动显示,差异有统计学意义(P<0.05),对青霉素G、苯唑西林、阿莫西林/克拉维酸钾、头孢唑林等耐药率变化,差异无统计学意义,未发现耐万古霉素、利奈唑胺菌株;3年耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为43.30%、38.10%、37.10%,差异无统计学意义。结论 SAU在住院患者各系统感染中均占有重要地位;SAU对不同抗菌药物的耐药率不同。OBJECTIVE To investigate the distribution and drug resistance of Staphylococcus aureus（SAU）isolated from hospitalized patients,so as to provide helpful information for further study of pathogenic activity and resistant mechanism of SAU.METHODS A total of 98127 samples from Jan.2012 to Dec.2014 were selected and retrospectively studied,including blood,pleural fluid and ascites,urine,secretion/abscess drain,postoperative drainage,bronchoalveolar lavage fluid,swabs and sputum.The distribution and drug resistance of SAU were analyzed.RESULTS Totally 20132 pathogenic bacterial strains were isolated from 98127 patients and the isolation rate was20.52%.Of these cases,1053 SA strains were identified and the isolation rate was 1.07%（1053/98127）.Totally 464 strains were isolated from lower respiratory tract,208 strains were isolated from secretion/abscess drain/drainage,60 strains were isolated from swabs,accounting for 4.07%,19.75%,and 5.70%.SAU were mainly in the department of respiration,pediatrics,and ICU,accounting for 17.19%,15.95%,and 11.30%.The drug resistance of SAU to ceftriaxone,ampicillin-sulbactam,and tetracycline showed significant difference between 2012 and 2014.The drug resistant rates to penicillin G,oxacillin,amoxicillin/potassium clavulanate and cefazolin had no significant difference.Vancomycin and linezolid-resistant strains had not been observed.The MRSA were43.30%,38.10%,and 37.10% in the past 3years,with no significant difference.CONCLUSION The above results demonstrate that SAU plays an important role in numerous infections for hospitalized patients,meanwhile,the difference in the distribution of MRSA and resistant rate of SA from different specimens can be observed.

关 键 词：金黄色葡萄球菌 标本来源 科室分布 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]