烧伤患者感染金黄色葡萄球菌耐药特征分析  

Analysis on drug resistance characteristics of burn patients infected with Staphylococcus aureus

作　　者：郭胜利 郭丽丽[2] 张书永 毛少明 任希莎 王力伟 张鹏 GUO Sheng-li;GUO Li-li;ZHANG Shu-yong;MAO Shao-ming;REN Xi-sha;WANG Li-wei;ZHANG Peng(Department of Laboratory Medicine,Hangang Hospital,Hebei 056001,China;不详)

机构地区：[1]邯郸邯钢医院检验科,河北056001 [2]邯郸市中心医院检验科 [3]中国铁路北京局集团有限公司石家庄卫生防疫站

出　　处：《医学动物防制》2022年第5期436-439,共4页Journal of Medical Pest Control

基　　金：河北省卫生行业科研基金资助项目(20181728)。

摘　　要：目的分析某院烧伤病房送检的485株金黄色葡萄球菌的分布特征及耐药状况。方法对2019—2020年某院烧伤病房送检的标本进行金黄色葡萄球菌分离培养、鉴定,并采用常用的MIC法对分离菌株进行药物敏感试验,对试验结果进行统计分析。结果共分离培养金黄色葡萄球菌485株,其中376株(77.5%)自伤面分泌物分离、85株(17.5%)自血液分离、24株(5.0%)自其它标本分离;甲氧西林耐药的金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA)检出率为74.2%。MRSA对红霉素、克林霉素、复方新诺明、利福平、四环素、氨基糖苷类和喹诺酮类抗菌药物的耐药率明显高于对甲氧西林敏感的金黄色葡萄球菌(methicillin sensitive Staphylococcus aureus,MSSA),MRSA对氯霉素、米诺环素、多西环素、替加环素耐药率分别为4.6%、7.7%、15.4%、1.5%;MSSA对氯霉素、米诺环素、多西环素、替加环素耐药率分别为6.3%、0%、0%、0%;MRSA和MSSA均对利奈唑胺、万古霉素、替考拉宁、达托霉素100.0%敏感。结论某院烧伤病房分离金黄色葡萄球菌菌株中MRSA检出率较高,且多重耐药菌株多见,临床需根据分离菌株药物敏感试验结果选择敏感抗菌药物。Objective To analyze the distribution characteristics and drug resistance of 485 Staphylococcus aureus strains submitted from the burn ward in a hospital.Methods The specimens submitted from the burn ward from 2019 to 2020 were subject to isolation,culture and identification of Staphylococcus aureus,and commonly used MIC method was applied to test the drug sensitivity of the isolated strain,and the test results were subject to statistical analysis.Results A total of 485 strains of Staphylococcus aureus were isolated and cultured.Wherein,376 strains(77.5%)were isolated from autolesion surface secretions,85 strains(17.5%)were isolated from blood,24 strains(5.0%)were isolated from other samples;the detection rate of methicillin resistant Staphylococcus aureus(MRSA)was 74.2%.The drug resistance rate of MRSA to erythromycin,clindamycin,cotrimoxazole,rifampicin,tetracycline,aminoglycosides and quinolones was significantly higher than that of MSSA,the drug resistance rates of MRSA to chloramphenicol,minocycline,doxycycline and tegecycline were 4.6%,7.7%,15.4%and 1.5%,respectively;the drug resistance rate of MSSA to chloramphenicol,minocycline,doxycycline and tegecycline was 6.3%,0%,0%and 0%,respectively.Both MRSA and MSSA were 100.0%sensitive to linezolid,vancomycin,teicoplanin and daptomycin.Conclusion The detection rate of MRSA is higher in the isolated Staphylococcus aureus isolates in a hospital,and the multiple drug resistantance strains are common,and the sensitive antibiotics should be selected according to the drug-sensitive results of the isolated strains.

关 键 词：金黄色葡萄球菌 感染 MRSA MSSA 多重耐药 烧伤 

分 类 号：R378.11[医药卫生—病原生物学] R644[医药卫生—基础医学]