骨科手术部位金黄色葡萄球菌感染及耐药性变化

目的 通过监测医院骨科手术部位金黄色葡萄球菌(SA)的感染情况及耐药性变化趋势,指导临床合理使用抗菌药物.方法 采用回顾性分析的方法,对2015年至2017年骨科手术患者的SA的分离结果及耐药性进行对比性分析.结果 三年间骨科患者手术部位SA的分离率和耐甲氧西林金黄色葡萄球菌(MRSA)构成比无明显差异(P>0.05),但MRSA的构成比从2015年的74.29%下降至2017年的52.46%,有明显下降,并具有统计学意义(P<0.05);SA对各类抗菌药物的耐药率无明显差异(P>0.05),数值上对苯唑西林、环丙沙星、莫西沙星和左氧氟沙星的耐药率呈下降趋势,但其耐药率仍高于50%;三年间SA对万古霉素、替考拉宁、利奈唑胺、呋喃妥因和喹奴普汀/达福普汀敏感率最高均为100.00%.结论 SA是骨科手术部位感染的主要病原菌,对各种抗菌药物的敏感性有较大差异,应该严格按照感染特点和病原菌药敏试验结果合理使用抗菌药物.

Objective To monitor the infection and drug resistance of Staphylococcus aureus in orthopaedic surgical sites in our hospital,and to guide the rational use of antibiotics in clinic.Methods The isolation and drug resistance of Staphylococcus aureus from orthopaedic surgery patients in our hospital from 2015 to 2017 were analyzed retrospectively.Results There was no significant difference in the separation rate of SA and the proportion of MRSA in the surgical site of orthopaedic patients during the three years(P>0.05),but the proportion of MRSA decreased from 74.29%in 2015 to 52.46%in 2017,with a significant decrease(P<0.05).There was no significant difference in the resistance rate of SA to various antibiotics(P>0.05).The resistance rate of SA to oxacillin,ciprofloxacin,moxifloxacin and levofloxacin showed a downward trend,but the resistance rate was still higher than 50%.In the past three years,the sensitivity rates of SA to vancomycin,teicoplanin,linezolid,furantoin and quinopristine/dafostine were all 100.00%.Conclusion Staphylococcus aureus is the main pathogen of orthopaedic surgical site infection.The sensitivity of Staphylococcus aureus to various antimicrobial agents varies greatly.Antimicrobial agents should be used reasonably according to the characteristics of infection and the results of antimicrobial susceptibility test.