2012-2015年金黄色葡萄球菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of Staphylococcus aureus strains isolated from 2012 to 2015

作　　者：王文[1] 蔡璇[2] 金松[1] 李春年[1] 吴小军[1] 

机构地区：[1]武汉大学人民医院呼吸内科,湖北武汉430060 [2]武汉大学人民医院检验科,湖北武汉430060

出　　处：《中华医院感染学杂志》2016年第21期4863-4865,4875,共4页Chinese Journal of Nosocomiology

基　　金：湖北省计划生育委员会项目资助(SJ-201209)

摘　　要：目的了解医院血培养中金黄色葡萄球菌的临床分布及耐药情况,为临床治疗提供依据。方法 2012年10月-2015年9月临床送检血培养阳性2 063份标本中分离出金黄色葡萄球菌234株,均采用BACTEC-FX BD全自动血培养仪进行血培养,阳性标本用BD全自动微生物鉴定/药敏仪Phoenix-100进行鉴定,应用WHONET5.5软件进行抗菌药物耐药性分析。结果血培养分离出金黄色葡萄球菌234株,其中耐甲氧西林金黄色葡萄球菌(MRSA)112株,3年中MRSA在金黄色葡萄球菌中平均发生率为47.9%;MRSA对阿米卡星、克林霉素、环丙沙星的耐药率均在55%以上,对红霉素耐药率甚至高达85%以上,但对磺胺甲噁唑/甲氧苄啶、奎奴普丁/达福普汀保持着较好的敏感性,尚未发现对万古霉素、替考拉宁、利奈唑胺耐药的菌株。结论血培养中金黄色葡萄球菌存在严重耐药,MRSA耐药性高,应加强MRSA耐药性监测,合理用药。OBJECTIVE To understand the clinical distribution and drug resistance of Staphylococcus aureus strains cultured from blood specimens so as to provide guidance for clinical treatment. METHODS A total of 234 strains of S. aureus were isolated from 2 063 blood specimens that were submitted from Oct 2012 to Sep 2015, the blood cul- ture was carried out by using BACTEC-FX BE） automatic blood culture system, the positive specimens were identi- fied by means of BD automatic microorganism identification/drug susceptibility system Phoenix-100, and the drug resistance was analyzed with the use of WHONET5.5 software. RESULTS Totally 234 strains of S. aureus were i- solated from the blood specimens, of which 112 were methicillin-resistant Staphylococcus aureus （MRSA）; the mean incidence of MRSA was 47.9% among the S. aureus strains in the three years. The drug resistance rates of the MRSA strains to amikacin, clindamycin, and ciprofloxacin were more than 55 %, the drug resistance rate to e- rythromycin was as high as 85%, however, the strains maintained highly susceptible to sulfamethoxazole-trime- thoprim and quinupristin-dalfopristin; the strains that were resistant to vancomycin, teicoplanin, or linezolid have not been detected. CONCLUSION The S. aureus strains isolated from the blood specimens are highly drug-resist- ant, the drug resistance rate of the MRSA strains is high. It is necessary to strengthen the surveillance of drug re- sistance of the MRSA strains and reasonably use antibiotics.

关 键 词：血培养 金黄色葡萄球菌 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]