2011-2015年甘肃省某医院金黄色葡萄球菌感染状况与耐药性分析  

The nosocomial infection by and drug resistance of Staphylococcus Aureus during 2011-2015 in Gansu Provincial Hospital

作　　者：朱吉超[1] 魏莲花[2] 杨永清[2] 邵海鑫 邹凤梅[2] 刘刚[2] 吴玲[2] 李军春[2] 魏勤[2] 王欣[2] 陈玉芊[2] 

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]甘肃省人民医院检验中心,甘肃兰州730000 [3]甘肃中医药大学,甘肃兰州730000

出　　处：《现代预防医学》2017年第6期1137-1140,1152,共5页Modern Preventive Medicine

基　　金：甘肃省卫生行业科研基金(GSWST2012-04)

摘　　要：目的了解2011-2015年甘肃省人民医院金黄色葡萄球菌(SAU)的临床分布及耐药性变化情况,为临床合理选择抗菌药物提供依据。方法收集2011-2015年各种临床标本中分离的SAU 1817株,采用K-B纸片扩散法进行抗菌药物敏感性试验,并用WHONET 5.6软件对药敏结果进行统计分析。结果 2011-2015年分离出SAU 1 817株,其中耐甲氧西林金黄色葡萄球菌(MRSA)807株,甲氧西林敏感金黄色葡萄球菌(MSSA)1 010株,两者分别占了44.4%和55.6%。SAU主要来源于痰液,占34.1%,其次是伤口分泌物,占27.1%;在科室分布中,前三位分别是烧伤科、神经外科、耳鼻喉科,SAU的检出率分别为25.9%(471/1 817)、9.5%(173/1 817)、9.2%(167/1 817)。MRSA对苯唑西林、青霉素G、头孢呋辛、头孢噻肟、头孢西丁、头孢唑林耐药率均为100.0%,而MSSA对青霉素G和红霉素的耐药率较高,分别为94.9%和69.8%;MRSA的耐药率普遍高于MSSA;未发现对万古霉素、利奈唑胺、替考拉宁均耐药的菌株。结论 MRSA在SAU中检出率较高,MRSA和MSSA对多种抗菌药物耐药率有明显差异,临床用药应根据药敏试验结果选用抗菌药物。Objective To understand the distribution characteristics and drug resistance of Staphylococcus aureus isolated from Gansun Prpovincial Hospital from 2011 to 2015, so as to provide the basis rational antibiotics usage. Methods Totally 1817 strains of S. aureus were isolated from various specimens collected from 2011 to 2015. The strain identification and drug susceptibility test to common antibiotics were performed by the K-B method. The statistical analysis was performed by WHONET 5.6 software. Results Totally 1817 strains of S.aureus were isolated in 5 years, among which 807 （44.4%） isolateswere Methicillin-resistant Staphylococcus aureus （MRSA） and 1010 （55.6%） were Methicillin-sensitive Staphylococcus aureus （MSSA）. S.aureus were mainly isolated from sputum, accounting for 34.1%, secondly from wound secretion, accounting for 27.1%. The detection rate ranking high to low among departments were 25.9% in the dapartment of burn , 9.5% in neurosurgery） and 9.2% in otolaryngology 0. The resistance of MRSA to oxacillin, penicillin G, cefuroxime, cefotaxime, cefoxitin, cefazolin was 100%, while the resistance of MSSA to penicillin G and erythromycin were94.9% and 69.8%, respectively. The resistance of MRSA was generally higher than that of MSSA. MRSA and MSSA were all sensitive to vancomycin, linezolid and teicoplanin. Conclusion Among the S.aureus isolates, of the detection rate of MRSA was higher than MSSA in this study. MRSA and MSSA showed significant difference in resistance to many antimicrobial agents. Clinical treatment should be based on antimicrobial susceptibility test.

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 医院感染 耐药率 

分 类 号：R378[医药卫生—病原生物学]