乳腺脓肿穿刺液标本病原菌分布及耐药性分析  

Distribution and antibiotic resistance of the pathogens in patients with breast abscesses

作　　者：贾忠兰[1] 许丽风[1] 毕福玲 

机构地区：[1]北京市海淀区妇幼保健院检验科,北京100080

出　　处：《中国微生态学杂志》2016年第12期1437-1439,共3页Chinese Journal of Microecology

摘　　要：目的探讨急性化脓性乳腺炎患者脓肿部位感染的病原菌及耐药性状况,指导临床合理使用抗菌药物。方法收集2014年1月至12月期间急性化脓性乳腺炎患者穿刺液标本780份,从中分离病原菌,用法国梅里埃公司生产的API鉴定系统进行细菌菌种鉴定,用K-B纸片扩散法做药敏试验。结果收集的780份标本中共分离出504株病原菌,分离率为64.6%,前五位的病原菌是金黄色葡萄球菌471株(其中MSSA 327株,MRSA 144株),占93.4%,表皮葡萄球菌16株(其中表皮葡萄球菌5株,MRSA11株),占3.2%,α-溶血链球菌11株,占2.2%,β-溶血链球菌4株(其中无乳链球菌3株,化脓性链球菌1株),占0.8%,其他凝固酶阴性葡萄球菌2株,占0.4%。其中327株MSSA对苯唑西林、头孢噻吩、头孢呋新、万古霉素100%敏感,对左氧氟沙星、呋喃妥因、复方磺胺甲唑、四环素、庆大霉素敏感率达90%以上,对青霉素、克林霉素、红霉素的耐药率较高。MRSA对青霉素类和头孢菌素类全部耐药,对克林霉素、红霉素耐药率较高,达80%以上,对左氧氟沙星、呋喃妥因、复方磺胺甲唑、庆大霉素敏感率达90%以上,没有发现对万古霉素耐药的MRSA。MRSA菌株对青霉素、苯唑西林、红霉素、克林霉素、四环素、头孢噻吩、头孢呋新的耐药性明显高于MSSA菌株,差异有统计学意义。结论急性化脓性乳腺炎患者感染的主要病原菌为金黄色葡萄球菌,包括MSSA和MRSA,MRSA对多种抗生素的耐药率明显高于MSSA,MSSA对苯唑西林、第I、II代头孢菌素敏感率较高,因此这些抗菌药物可以作为首选药治疗MSSA引起的急性化脓性乳腺炎,但MRSA对多种抗生素耐药率较高,治疗MRSA引起的急性化脓性乳腺炎,应根据药敏试验结果选用敏感药物。Objective To explore the distribution and antibiotic susceptibility of the pathogens in patients with breast abscesses. Methods The pathogens were isolated from patients with breast abscesses from January to December in 2014. The identification of pathogens was performed with API identification system and the susceptibility test was detected by disk diffusion method. Results A total of 504 strains were isolated. The major pathogens were Staphylococcus aureus, including 327 strains of methicillin-susceptible Staphylococcus aureus （MSSA） and 144 strains of methicillin-resistant Staphylococcus aureus （MRSA） . No vancomycin-resistant Staphylococcus aureus was detected. The resistance rate of MSSA to penicillin was 80.7%, while its sensitivity rate to oxacillin was 100.0%. The resistance rates of MRSA to penicillin and oxacillin were 100.0%. Conclusion The major pathogens in patients with breast abscesses were Staphylococcus aureus. The first choices for infections caused by MSSA were oxacillin and cephalosporins I or II. MRSA strains with mecA were resistant to many antimicrobial agents, so must be monitored carefully.

关 键 词：乳腺 脓肿 金黄色葡萄球菌 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]