耐甲氧西林金黄色葡萄球菌感染病例的耐药调查及用药分析  

The Investigation of Drug-Resistance and Drug Utilization of 294 Cases of Methicillin-Resistant Staphylococcus Aureus Infection

作　　者：吴晓龙 张云芳 殷娜 吉建 WU Xiaolong;ZHANG Yunfang;YIN Na;JI Jian(Luoyang Orthopedic Hospital(Henan Provincial Orthopaedic Hospital),Luoyang Henan 471002,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院),河南洛阳471002

出　　处：《临床研究》2020年第3期20-22,共3页Clinical Research

基　　金：河南省中医药科学研究专项课题(2017ZY2086)。

摘　　要：目的调查骨科医院住院患者耐甲氧西林金黄色葡萄球菌(MRSA)的耐药现状及临床用药情况。方法对河南省洛阳正骨医院2015年1月-2017年12月294例分离出MRSA住院患者的药敏结果和药物应用情况进行回顾性分析。结果MRSA对奎奴普丁-达福普汀、替考拉宁、夫西地酸、吗啉噁酮、呋喃妥因、万古霉素的敏感率均达到90%以上,对其他的抗菌药物耐药情况严重。294例MRSA感染患者采用抗菌药物治疗的有273例,经验用药中选择头孢菌素类、氨基糖苷类、喹诺酮类比例较高,依次为35.2%,23.1%和20.9%;药敏报告后用药以夫西地酸钠、氨基糖苷类和糖肽类比例较高,依次为47.3%,28.6%,22.0%。药敏报告后单药应用比例由经验用药的95.6%下降为72.5%,二联用药由4.4%上升为26.4%。结论MRSA感染及耐药情况日趋严重,应引起足够的重视,加强经验用药知识,及时进行细菌培养及药敏试验,选用敏感抗菌药物,有利于抗菌药物的合理应用。Objective To investigate the status of drug resistance and drug clinical use of methicillin-resistant Staphylococcus aureus(MRSA)in patients in orthopaedic hospitals.Method A retrospective analysis of the drug sensitivity and drug application isolated from 294 patients with MRSA in hospital from January 2015 to December 2017 were performed in Luoyang Orthopedic Hospital.Results MRSA had an sensitivity more than 90%to quinoupdine,dafoptin,teicoplanin,fusidic acid,Linezolid,macrodantin and vancomycin,but it has a severe resistance to other antimicrobial drugs.273 cases were treated with antimicrobial drugs in 294 patients infected with MRSA,with a high proportion of empirical drugs,the utilization of cephalosporinsin,aminoglycoside and quinolones were 35.2%,23.1%and 20.9%,respectively;After the drug sensitivity report,the utilization of cephalosporinsin,aminoglycoside and quinolones were 47.3%,28.6%and 22.0%,respectively.The proportion of single-drug application decreased from 95.6%of empirical drug use to 72.5%,and the proportion of dual-use drugs increased from 4.4%to 26.4%.Conclusion MRSA infection and drug resistance is becoming more and more serious,enough attention should be paid to strengthen the knowledge of empirical drug use,bacterial culture and drug sensitivity test should be carried out in time.We need to choose sensitive antibacterial drugs,which is conducive to the rational application of antimicrobial drugs.

关 键 词：耐甲氧西林金黄色葡萄球菌 耐药性 抗生素 用药分析 

分 类 号：R9[医药卫生—药学]