急性乳腺炎患者病原菌的耐药性研究  

The study of drug resistance of pathogenic bacteria in patients with acute mastitis

作　　者：连炬飞[1] 曾丽[1] 曾文[1] 叶青[1] 欧阳凯[1] LIAN Jufei;ZENG Li;ZENG Wen;YE Qing;OUYANG Kai(Department of Clinical Laboratory,GuangDong Women and Children Hospital,Guangzhou,Guangdong 510010,China)

机构地区：[1]广东省妇幼保健院检验科,广东广州510010

出　　处：《检验医学与临床》2021年第24期3583-3587,共5页Laboratory Medicine and Clinic

摘　　要：目的分析急性乳腺炎患者病原菌的耐药情况,为临床合理使用抗菌药物提供参考依据。方法回顾性分析2016年1月至2020年12月于该院治疗的1665例急性乳腺炎患者的病原菌鉴定及药敏试验结果,并进行统计学分析。结果1665例患者中共分离出984株病原菌,检出率为59.10%;共分离出金黄色葡萄球菌815株,检出率为48.95%,构成比为82.83%,其中耐甲氧西林金黄色葡萄球菌(MRSA)318株,检出率为19.10%;共分离出铜绿假单胞菌87株,检出率为5.23%,构成比为8.84%;共分离出表皮葡萄球菌47株,检出率为2.82%,构成比为4.78%。2016-2020年,金黄色葡萄球菌和MRSA检出率逐年递增。金黄色葡萄球菌2016-2019年各年份的检出率与2020年比较,差异均有统计学意义(P<0.05)。金黄色葡萄球菌对青霉素的耐药性率最高,对红霉素、克林霉素、庆大霉素、四环素、苯唑西林、复方磺胺甲噁唑、左氧氟沙星、环丙沙星、利福平、复方磺胺甲噁唑的耐药性一般,对呋喃妥因、替考拉宁的耐药性极低,对万古霉素、利奈唑胺无耐药。结论急性乳腺炎患者金黄色葡萄球菌的检出率较高,耐药情况严峻,应重视耐药监测与分析,指导临床合理用药。Objective To analyze the drug resistance changes of pathogenic bacteria in patients with acute mastitis,and provide reference for the rational use of antibiotics in clinical practice.Methods Bacterial identification and drug sensitivity results of 1665 patients with acute mastitis treated in the hospital from January 2016 to December 2020 were analyzed retrospectively,and statistical analysis was conducted.Results A total of 984 strains of bacteria were isolated from the 1665 patients,with a detection rate of 59.10%.A total of 815 strains of Staphylococcus aureus were detected with a detection rate of 48.95%and a composition ratio of 82.83%.Among them,318 strains of MRSA were detected with a detection rate of 19.10%.A total of 87 strains of Pseudomonas aeruginosa were detected with a detection rate of 5.23%and a composition ratio of 8.84%.A total of 47 strains of Staphylococcus epidermidis were detected with a detection rate of 2.82%and a composition ratio of 4.78%.From 2016 to 2020,the detection rate of Staphylococcus aureus and MRSA increased year by year,and the detection rate of Staphylococcus aureus from 2016 to 2019 was statistically significant different from that of 2020(P<0.05).Staphylococcus aureus had the highest resistance to penicillin and showed general resistance to erythromycin,clindamycin,gentamicin,tetracycline,benzoxicillin,compound sulfamethoxazole,levofloxacin,ciprofloxacin,rifampicin and compound noxamine.Staphylococcus aureus showed very low resistance to furantoin and tekoranin and no resistance to vancomycin and linezolid.Conclusion The detection rate of Staphylococcus aureus in patients with acute mastitis is high,and the drug resistance is severe.Therefore,attention should be paid to early monitoring and analysis of drug resistance and rational drug use in clinical practice.

关 键 词：急性乳腺炎 金黄色葡萄球菌 细菌鉴定 耐药性 

分 类 号：R446.5[医药卫生—诊断学]