2009—2019年北京世纪坛医院金黄色葡萄球菌临床感染分布及耐药性分析  

Distribution and drug resistance of Staphylococcus aureus in a hospital, 2009—2019

作　　者：孙盼盼 菅记涌[1,2,3] 解泽强 全秀秀[1,2,3] 唐圣闻 陈亮[1,2,3] SUN Pan-pan;JIAN Ji-yong;XIE Ze-qiang;QUAN Xiu-xiu;TANG Sheng-wen;CHEN Liang(Clinical Laboratory Medicine,Beijing Shijitan Hospitaly Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院医学检验科,100038 [2]北京大学第九临床医学院 [3]首都医科大学尿液细胞分子诊断北京市重点实验室,100038

出　　处：《现代预防医学》2021年第7期1305-1309,共5页Modern Preventive Medicine

基　　金：尿液细胞分子诊断北京市重点实验室建设经费(2019-JS02);院青年基金(2018-q05);院青年基金(2017-q43)。

摘　　要：目的回顾性分析金黄色葡萄球菌(Staphylococcus aureus,SAU,SAU)及耐甲氧西林金黄色葡萄球菌(Methicillin Resistant Staphylococcus aureus,MRSA)临床感染分布及耐药性,为临床合理选用抗菌药物提供依据。方法收集北京世纪坛医院2009—2019年临床样本中分离的SAU,采用VITEK-2 Compact全自动药敏鉴定仪进行细菌鉴定及药敏试验。结果分离出SAU 4 535株,其中MRSA 3 142株(69.3%);SAU主要来自痰(62.9%)、伤口分泌物(16.6%);MRSA主要来自痰(75.2%)、拭子(8.1%)。分离出SAU前3位的科室是重症医学科(ICU)(21.1%)、呼吸科(16.6%)、神经外科(7.1%);分离出MRSA前3位的科室是ICU (24.9%)、呼吸科(22.2%)、神经内科(8.1%)。本研究未检出万古霉素、利奈唑胺耐药株。SAU对青霉素、苯唑西林、左氧氟沙星、四环素、庆大霉素、莫西沙星、环丙沙星、利福平耐药率呈下降趋势,对复方新诺明呈上升趋势。MRSA对红霉素、环丙沙星、利福平、莫西沙星、庆大霉素、四环素、左氧氟沙星、青霉素耐药率均高于75%;相较SAU,以上抗生素及苯唑西林、克林霉素、复方新诺明差异具有统计学意义(P<0.01)。结论我院SAU及MRSA分离率呈逐年降低趋势,MRSA仍具有较高耐药性,应加强监测并高度重视,合理科学地使用抗生素。Objective To analyze the clinical distribution and antimicrobial resistance of Staphylococcus aureus(SAU) and Methicillin-resistant Staphylococcus aureus(MRSA) in the hospital, and to guide the rational use of antibiotics and to provide basis for the prevention control of nosocomial infection. Methods The SAU strains were collected from clinical specimens in Beijing Shijitan hospital from 2009 to 2019. Identification and antibiotic susceptibility tests(AST) were carried out by VITEK-2 Compact automatic susceptibility identification analyzer. Results A total of 4 535 SAU strains were isolated from 2009 to 2019, in which 3 142 strains were identified as MRSA, with the isolation rate of 69.3%. The top 2 specimens isolated SAU were sputum(62.9%) and secretion(16.6%), but for MRSA, they were sputum(75.2%) and throat swabs(8.1%). The top 3 departments isolated SAU were Intensive Care Unit(ICU)(75.2%), the Department of Respiration(16.6%), Neurosurgery(7.1%), while for MRSA, they were ICU(24.9%), the Department of Respiration(22.2%), Neurology(8.1%) respectively. Vancomycin and linezolid resistant strains were not found in the research. For SAU, the resistant rate to Penicillin, Oxacillin, Levofloxacin, Tetracycline, Gentamicin, Moxifloxacin, Ciprofloxacin, Rifampicin were gradually decreasing yearly. But to Sulfamethoxazole was in the opposite. For MRSA, the resistant rate to Erythromycin, Ciprofloxacin, Rifampicin Moxifloxacin, Gentamicin, Tetracycline Levofloxacin, Penicillin were all up to 75%. The resistant rate of MRSA to the above antibiotics and Oxacillin, Clindamycin, Sulfamethoxazole were higher than that of SAU(P<0.01). Conclusion The detection rate of SAU and MRSA is decreasing yearly, but the resistant rate of MRSA to common antibiotics are serious. Clinical departments should make reasonable using of antibiotics and strengthen hospital infection control to decrease the incidence of MRSA infection.

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 临床分布 耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]