2018-2023年山东地区某医院金黄色葡萄球菌血液分离株的临床分布及耐药性分析  

Clinical distribution and drug resistance analysis of blood isolates of Staphylococcus aureus from a hospital in Shandong from 2018 to 2023

作　　者：冯莉娅 崔晓笛 刘珂 董秀涛[1] 李晓凤 郝明巨[1] 石晓红[1] FENG Li-ya;CUI Xiao-di;LIU Ke(Department of Clinical Laboratory Medicine,The First Afiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Jinan 250014)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)检验科,山东济南250014

出　　处：《医学检验与临床》2025年第2期25-29,84,共6页Medical Laboratory Science and Clinics

基　　金：葡萄球菌持留菌耐药机制研究,项目编号:2022013。

摘　　要：目的:了解山东第一医科大学第一附属医院血标本中金黄色葡萄球菌(Staphylococcus aureus,SAU)的临床分布情况并分析其耐药性变化。方法:收集山东第一医科大学第一附属医院2018年1月-2023年12月临床血标本中非重复分离的金黄色葡萄球菌,通过Bruker MALDI-TOF或VITEK-2 Compact自动化细菌鉴定仪进行细菌鉴定,纸片扩散法或VITEK-2 Compact自动化药敏系统进行药物敏感性测定,回顾性分析药敏结果。药敏结果判断采用2023年CLSIM100中规定的折点。使用WHONET 2023、SPSS25.0和Graphpad Prism 8.0软件对数据进行分析。结果:2018-2023年六年间在血标本中分离出的金黄色葡萄球菌共309株,占比8.06%,其中对甲氧西林耐药的SAU菌株(MRSA)77株,占比24.92%。科室分布主要为肾内科(22.33%)、ICU(20.39%)、儿科(7.77%)、肿瘤科(5.18%)、血液内科(4.85%)等。药敏情况:6年间SAU菌株对苯唑西林耐药率呈迁回下降趋势,其中2021年最高(31.48%)。SAU对青霉素呈现高耐药率,未发现对利奈唑胺、万古霉素等耐药的SAU菌株;对复方新诺明、庆大霉素、四环素等的耐药率呈明显的下降趋势。结论:SAU患者临床分布广泛,我院血标本中SAU感染较集中的科室是肾内科、ICU和儿科,好发于中老年患者。应持续提高标本送检率,提升标本送检质量,持续做好细菌耐药性监测和抗菌药物管理,积极倡导临床抗生素的合理使用,为临床提供用药指导,降低耐药率。Objective:To understand the clinical distribution of Staphylococcus aureus(SAU)in the First Afiliated Hospital of Shandong First Medical University and analyze its drug resistance changes.Methods:Non-repeated isolates of Staphylococcus aureus from various clinical specimens in the First Affiliated Hospital of Shandong First Medical University during January 2018 to December 2022 were collected.Bacterial identification was carried out by Bruker MALDI-TOF or VITEK-2 Compact automated bacterial identification instrument.Antibiotic susceptibility test(AST)was performed by disk difusion method or VITEK-2 Compact system.The drug susceptibility was determined according to the 2022 CLSI M100.Statistics analysis was performed using WHONET 2023,SPSS 25.0 and Graphpad Prism 8.0 software.Results:A total of 309 isolates were detected in the six years from 2018 to 2023from blood samples,with a detection rate of 9.96%.Among them,77 strains of methicillin-resistant SAU(MRSA)were identified,accounting for 24.92%.The distribution of departments mainly includes nephrology(22.33%),ICU(20.39%),pediatrics(7.77%),oncology(5.18%),hematology(4.85%),etc.Drugsusceptibility:The resistance rate of SAU strains to oxacillin has shown a downward trend over the past 6 years,with the highest in 2021(31.48%).SAU showed a high resistance rate to penicillin,and no SAU strains resistant to linezolid,vancomycin,etc.were found;The resistance rate to compound sulfamethoxazole,gentamicin,tetracycline,etc.shows a significant downward trend.Conclusion:SAU patients are widely distributed in the clinic,we should continue to improve the specimen delivery rate,enhance the quality of specimen delivery,increase the proportion of specimens delivered from sterile sites,continue to do a good job of bacterial resistance monitoring and antimicrobial drug management,and actively advocate the rational use of clinical antibiotics to provide clinical guidance on medication use and reduce the rate of drug resistance.

关 键 词：金黄色葡萄球菌 临床分布 抗生素 耐药率 血标本 

分 类 号：R44[医药卫生—诊断学]