老年患者金黄色葡萄球菌临床分布及耐药分析  

Analysis of the Clinical Distribution and Drug Resistance of Staphylococcus aureus in Elderly Patients

作　　者：杨建科[1] 王燕玲[1] 孙菱 郑春莲[1] 成莉 黄原[2] Yang jian-ke;Wang yan-ling;Sun ling;Zheng chun-lian;Cheng li;Huang yuan(Medical Laboratory Department of People's Hospital of Leshan City,Leshan 614000;Medical Laboratory Department of West China Fourth Hospital,Chengdu 610000)

机构地区：[1]四川省乐山市人民医院检验科,乐山614000 [2]四川大学华西第四医院检验科,成都610000

出　　处：《国外医药（抗生素分册）》2021年第5期308-311,共4页World Notes on Antibiotics

摘　　要：目的分析老年患者金黄色葡萄球菌(SAU)临床分布特征及耐药性,为指导临床合理用药提供参考依据。方法收集乐山市三所三级甲等医院2018—2019年临床分离菌株,分为老年组和非老年组,分别对两组患者SAU检出构成比、标本来源、抗菌药物耐药率、甲氧西林耐药SAU(MRSA)和甲氧西林敏感SAU(MSSA)检出率及其耐药性进行比较分析。结果临床分离的12321株细菌中共检出SAU 913株,SAU检出构成比6.85%(913/12321),非老年组SAU检出构成比高于老年组;标本来源中老年组痰液SAU检出构成比高于非老年组(χ^(2)=47.03,P<0.01),脓液SAU检出构成比低于非老年组(χ^(2)=5.07,P<0.05);MRSA和MSSA检出构成比两组间无差异(χ^(2)=0.05,P>0.05),但老年组对莫西沙星等抗菌药物的耐药率高于非老年组(P均<0.05)。结论老年患者呼吸道感染SAU的风险高于非老年患者;两组间MRSA检出构成比虽无差异,但对抗菌药物耐药性上具有差异性。临床治疗时应考虑老年患者的耐药特征,根据体外药敏实验结果和患者的临床表现,合理选择抗菌药物。Objective To analyze the clinical distribution characteristic and drug resistance of Staphylococcus aureus(SAU)in the elderly inpatients in the city of Leshan,Sichuan Province,and to provide a reference for rational clinical antibiotic use.Methods The clinical strain isolates from three 3A Grade hospitals from 2018 to 2019 in Leshan city were collected They were divided into two groups,the elderly and non-elderly groups.The composition ratio of SAU,the distribution of specimen sources,the rate of antibacterial resistance,the detection rate and drug resistance of methicillin-resistant(MRSA)and methicillin-sensitive SAU(MSSA)were all comparatively analyzed.Results A total of 913 SAU strains were detected clinically among the 12321 clinically isolated strains.The composition ratio of SAU detection was 6.85%(913/12321),and this ratio is higher in the non-elderly group than the elderly group from the aspect of the source of specimens.The composition ratio of SAU detection from sputum in the elderly group was higher than that of the non-elderly group(χ^(2)=47.03,P<0.01),and the composition ratio of SAU from pus in the elderly group was lower than the non-elderly group(χ^(2)=5.07,P<0.05).There was no difference in the composition ratio of MRSA and MSSA between the elderly group and the non-elderly group(χ^(2)=0.05,P>0.05),however,the rate of antibacterial resistance to moxifloxacin and other antibacterial drugs in the elderly group was higher than non-elderly group(all P<0.05).Conclusion The risk of SAU for respiratory tract infection in elderly patients is higher than that of in the non-elderly patients.There was no difference in composition ratio of MRSA between the two groups.However there was some difference in the rate of antibacterial resistance.Clinical treatment for patients in the elderly age group should consider the drug resistance characteristics of the population.According to the results from susceptibility testing and the clinical features of patients,the clinicians should select appropriate antibacteri

关 键 词：金黄色葡萄球菌 耐药率 抗菌药物 老年人群 耐甲氧西林金黄色葡萄球菌 

分 类 号：R978.1[医药卫生—药品]