住院患者耐甲氧西林金黄色葡萄球菌感染及耐药分析  

Analysis of methicillin-resistant Staphylococcus Aureus infection and drug resistance in inpatients

作　　者：杜杰[1] 吴琳 王忠 DU Jie;WU Lin;WANG Zhong(Xingtai People's Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]邢台市人民医院,河北邢台054000

出　　处：《中国病原生物学杂志》2025年第5期614-618,共5页Journal of Pathogen Biology

基　　金：2023年度河北省医学科学研究课题计划(No.20232018)。

摘　　要：目的探讨住院患者耐甲氧西林金黄色葡萄球菌(MRSA)感染及耐药情况,为临床治疗提供参考。方法对本院2021-2023年住院患者送检的790株金黄色葡萄球菌进行回顾性分析,统计不同年份、不同科室、不同标本MRSA的检出率,对比MRSA与MSSA菌株的耐药性及MRSA的耐药基因携带情况。结果2021-2023年共检出260株MRSA,检出率为32.91%(260/790)。2021年MRSA检出率为37.96%(82/216),2022年为32.89%(75/228),2023年为29.77%(103/346)。2021-2023年MRSA检出率呈逐年下降趋势,不同年份MRSA检出率差异无统计学意义(P>0.05)。260株MRSA菌株中,烧伤整形外科占比最高为18.46%(48/260),骨科、综合ICU、感染科、普外科、耳鼻喉科、急诊科、肾内科、神经ICU、呼吸与危重症医学科、神经外科、儿科、新生儿科、脑血管病区、内分泌科、血液科、产科的占比分别为12.31%(32/260)、10.38%(27/260)、9.62%(25/260)、8.46%(22/260)、7.69%(20/260)、6.54%(17/260)、5.77%(15/260)、5%(13/260)、3.85%(10/260)、2.69%(7/260)、2.31%(6/260)、2.31%(6/260)、1.92%(5/260)、1.15%(3/260)、0.77%(2/260)、0.77%(2/260)。MRSA检出率前四位的科室依次为急诊科、烧伤整形外科、感染科、呼吸与危重症医学科。260株MRSA菌株中,痰液标本占比最高为20.77%(54/260),伤口分泌物、全血、脓液、组织分泌物、穿刺管尖端、引流液、中段尿、肺泡灌洗液、关节腔积液、脑脊液、肠道分泌物、粪便标本分别占16.54%(43/260)、12.31%(32/260)、9.62%(25/260)、8.46%(22/260)、7.69%(20/260)、5.77%(15/260)、4.23%(11/260)、3.85%(10/260)、3.08%(8/260)、3.08%(8/260)、2.69%(7/260)、1.92%(5/260)。MRSA检出率前四位的标本类型分别为伤口分泌物、脓液、肺泡灌洗液、脑脊液。MRSA菌株对青霉素的耐药率为100%,对红霉素、克林霉素、左氧氟沙星、四环素、庆大霉素、环丙沙星的耐药率均高于50%,未产生对万古霉素、替考拉宁的耐药株。MSSA菌株对青霉Objective To explore the infection and drug resistance of methicillin-resistant Staphylococcus aureus(MRSA)in inpatients,and to provide references for clinical treatment.Methods A retrospective analysis was conducted on 790 strains of Staphylococcus aureus submitted for testing from inpatients in our hospital from 2021 to 2023.The detection rates of methicillin-resistant S.aureus(MRSA)in different years,different departments and different specimens were counted.The drug resistance of MRSA and methicillin-sensitive S.aureus(MSSA)strains were compared,and the carriage of drug resistance genes in MRSA were detected.Results A total of 260 strains of MRSA were detected from 2021 to 2023,with a detection rate of 32.91%(260/790).In 2021,the detection rate of MRSA was 37.96%(82/216).In 2022,the detection rate of MRSA was 32.89%(75/228).In 2023,the detection rate of MRSA was 29.77%(103/346).From 2021 to 2023,the detection rate of MRSA showed a downward trend year by year,and the difference in the detection rates of MRSA among different years was not statistically significant(P>0.05).Among the 260 strains of MRSA,the Department of Burn and Plastic Surgery had the highest proportion,accounting for 18.46%(48/260).The proportions in the Department of Orthopedics,General Intensive Care Unit(ICU),Department of Infectious Diseases,General Surgery Department,Department of Otorhinolaryngology,Emergency Department,Department of Nephrology,Neurosurgery ICU,Department of Respiratory and Critical Care Medicine,Department of Neurosurgery,Department of Pediatrics,Department of Neonatology,Cerebrovascular Disease Ward,Department of Endocrinology,Department of Hematology,and Department of Obstetrics were 12.31%(32/260),10.38%(27/260),9.62%(25/260),8.46%(22/260),7.69%(20/260),6.54%(17/260),5.77%(15/260),5%(13/260),3.85%(10/260),2.69%(7/260),2.31%(6/260),2.31%(6/260),1.92%(5/260),1.15%(3/260),0.77%(2/260),and 0.77%(2/260),respectively.The top four departments with the highest MRSA detection rates were the Emergency Department,the Department

关 键 词：耐甲氧西林金黄色葡萄球菌 耐药性 耐药基因 

分 类 号：R446.5[医药卫生—诊断学]