医院与社区获得性耐甲氧西林金黄色葡萄球菌耐药性的研究

Drug Resistance of Meticillin-resistant Staphylococcus aureus

目的为比较医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)与社区获得性MRSA的耐药性,以期为临床有效防治MRSA提供科学依据. 方法收集2002～2004年从各临床标本中分离出的不重复MRSA菌株, 参照卫生部医政司医院感染监控小组制定的诊断标准,将其分为社区获得性MRSA组与医院获得性MRSA两组,各组随机各取20株作为本试验的试验对象;对两组的耐药率进行配对t检验,并就其耐药性及原因进行分析. 结果社区获得性MRSA、医院获得性MRSA耐药性存在差异,医院获得性MRSA较社区获得性MRSA耐药性高. 结论 MRSA的出现是高抗生素选择压力的结果;医院获得性MRSA较社区获得性MRSA耐药性差异确实存在统计学的显著性,尤其对阿莫西林/克拉维酸、氨苄西林/舒巴坦、头孢唑林、克林霉素的耐药性差异明显; MRSA菌株多具有多重耐药性.

OBJECTIVE To analyze the drug resistance of the clinical meticillin-resistant Staphylococcus aureus(MRSA) and discuss the reason of resistance development through finding the difference of the drug resistance between community-acquired MRSA(C-MRSA) and hospital-acquired MRSA(H-MRSA) and analyzing the reason, to afford some scientific base for the effective prevention and cure to MRSA. METHODS We collected unrepeated MRSA strains from clinical specimens, divided them into two groups: C-MRSA and H-MRSA, and randomly sampled 20 strains from each group as study objects. By paired-samples t test, we analyzed the resistant difference between two groups. With clinical information, we discussed the reasons of it. RESULTS The difference between them was significant and the resistance of H-MRSA was higher than C-MRSA. CONCLUSIONS The emergence of MRSA is the result of high antibiotic selective pressure. There are significant difference between the resistance of H-MRSA and C-MRSA,especially to amoxicillin/clavulanic acid, ampicillin/sulbactam, cefazolin, and clindamycin. Multi-drug resistance is one important character of MRSA.