医院葡萄球菌属临床分离株的耐药性

Drug-resistance of Staphylococcus Isolated from the Hospital

目的研究葡萄球菌属的耐药趋势及变迁,以探讨临床常见葡萄球菌属分离株的耐药性现状,为葡萄球菌感染提供选药依据。方法对2000～2003年我院临床分离的常见葡萄球菌,采用KirbyBauer法进行药敏试验,高盐琼脂扩散法对苯唑西林耐药的菌株做耐甲氧西林葡萄球菌(MRS)测定,按美国临床实验室标准化委员会(NCCLS)1999年标准判断结果。结果近4年临床分离到的前9位细菌共6602株,金黄色葡萄球菌(SAU)、凝固酶阴性葡萄球菌(CNS)分别占第2位(977株,占14.4%)和第6位(607株,占8.9%);MRSA、MRCNS的检出率分别为84%和86.3%,环丙沙星、红霉素、克林霉素、复方新诺明对其耐药率均>40%;头孢唑林对MRSA呈高度耐药(>90%),对MRCNS耐药率<40%;未发现耐万古霉素菌株。结论近4年临床分离菌仍以革兰阴性菌为主,但SAU和CNS亦占相当比例,且MRSA和MRCNS呈高分离率,应合理使用抗菌药物及采取其他有效措施控制MRS的感染。

OBJECTIVE To investigate the drug-resistance of Staphylococcus species isolated from clinic in our hospital from 2000 to 2003, so as to provide the reference for choosing antibiotics of empirical therapy of bacterial infection. METHODS Using K-B antibacterial disk susceptibility test, the drug-resistance of 977 Staphylococcus aureus （SAU） strains and 607 coagulase negative Staphylococcus （CNS） strains from patients was measured. Meticillin-resistant SAU and CNS from them were detected by using the method of salt agar screen. RESULTS Among 977 SAU strains （14.4%） and 607 CNS strains （8.9%） of 6 602 strains of first 9 pathogens isolated from patients from 2000 to 2003 in our hospital, 821 MRSA strains and 524 MRCNS strains were detected （84% and 86.3 %）. The drug-resistant rate of MRS to ciprofloxacin, erythromycin, clindamycin and compound sulfamethoxazole was all over 40%. The drug-resistant rate of MRSA to cefazolin was high （〉90%）, and the drug-resistant rate of MRCNS to cefazolin was low （〈40%）. There was no drug-resistant Staphylococcus strain to vancomycin being found. CONCLUSIONS Gram negative bacilli ware also the most commom pathogens isolated from clinic in our hospital, and there is a high proportion of MRSA and MRCNS. MRS production has increased in last 4 years. Measures should be taken to control the spread of MRS strain.