246株耐甲氧西林金黄色葡萄球菌医院感染的调查与耐药性分析  

Investigation and drug resistance analysis of 246 strains of methicillin-resistant Staphylococcus aureus nosocomial infection

作　　者：文珊[1] 施颖 粟永俊[2] 秦艳娥[3] 王艳宁[3] WEN Shan;SHI Ying;SU Yongjun;QIN Yan’e;WANG Yanning(Department of Infection Control,The First People’s Hospital of Nanning,Nanning 530022,China;Department of Clinical Laboratory,The First People’s Hospital of Nanning,Nanning 530022,China;Department of Pharmacy,The First People’s Hospital of Nanning,Nanning 530022,China)

机构地区：[1]广西南宁市第一人民医院感控科,南宁530022 [2]广西南宁市第一人民医院检验科,南宁530022 [3]广西南宁市第一人民医院药学部,南宁530022

出　　处：《右江医学》2018年第5期584-588,共5页Chinese Youjiang Medical Journal

摘　　要：目的探讨耐甲氧西林金黄色葡萄球菌(MRSA)医院感染的分布情况及耐药性。方法收集2015年1月~2017年12月医院临床科室分离出的246株MRSA,采用微量肉汤稀释法对246株MRSA进行药敏试验,分析标本来源分布,并对12种常用抗菌药物进行药敏试验。结果 MRSA的总检出率为34.55%,三年来连续居第一排位,并且有不断上升趋势(P<0.05);标本来源主要为痰液、分泌物、肺泡灌洗液和血液,检出率分别为37.40%、28.86%、13. 41%和10.96%,差异有统计学意义; MRSA医院感染主要集中在ICU、神经外科、老年病学科和胸心外科等科室;药物敏感试验结果显示,MRSA对青霉素类抗菌药物耐药率高达100%,磺胺类为21.1%,氨基糖甙类为68.3%,克林霉素为85.8%,喹诺酮类为45.5%~63.8%,四环素类64.6%;对万古霉素和利奈唑胺均敏感。结论耐甲氧西林金黄色葡萄球菌有较高的检出率和耐药性,临床应根据送检结果合理选用抗菌药物,落实感控措施,避免产生耐药性,预防与控制医院感染的扩散与暴发。Objective To investigate the distribution and drug resistance of methicillin-resistant Staphylococcus aureus(MRSA).Methods 246 strains of MRSA separated from the clinical departments of the hospital between January 2015 and December 2017 were collected.The drug sensitivity test of 246 strains of MRSA was carried out by broth dilution method,the distribution of the samples was analyzed,and the susceptibility test of 12 common antimicrobial agents was carried out.Results The total detection rate of MRSA was 34.55%,it had ranked first for three consecutive years with a rising trend(P<0.05).The samples were mainly from sputum,secretions,alveolar lavage fluid and blood,and the detection rate was 37.40%,28.86%,13.41%and 10.96%,respectively,so difference was statistically significant.MRSA nosocomial infection mainly concentrated in ICU,Department of Neurosurgery,Department of Geriatrics and Department of Cardiothoracic Surgery,etc.The results of drug sensitivity test showed that the resistance rate of MRSA to penicillin antibiotics was as high as 100%,sulfonamides was 21.1%,aminoglycoside was 68.3%,clindamycin was 85.8%,quinolone was 45.5%~63.8%and tetracycline was 64.6%.MRSA were also sensitive to both vancomycin and linezolid.Conclusion MRSA has high detection rate and drug resistance.According to the results of clinical examination,antibiotics should be reasonably selected,the sensible control measures should be carried out to avoid drug resistance,and the spread and outbreak of nosocomial infection should be prevented and controlled in clinical practice.

关 键 词：耐甲氧西林金黄色葡萄球菌 医院感染 耐药性 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]