综合医院感染耐甲氧西林金黄色葡萄球菌耐药性监测

Drug-resistance Status of Meticillin-resistant Staphylococcus aureus Isolated from Clinic Hospital

目的调查医院临床分离耐甲氧西林金黄色葡萄球菌(MRSA)对抗菌药物的耐药现状,为临床治疗用药提供参考。方法采用法国生物梅里埃公司ATB分析仪进行细菌鉴定,K-B法做体外药敏试验。结果 181株金黄色葡萄球菌中MRSA检出率为58.0%,MRSA检出率以老年病科最高(73.5%),其次是普外科(69.4%)及骨外科(61.9%);社区获得性感染MRSA检出率远低于住院患者;药敏结果显示,MRSA耐药率明显高于甲氧西林敏感金黄色葡萄球菌(MSSA),未检出对万古霉素及替考拉宁耐药菌株。结论金黄色葡萄球菌耐药严重,MRSA的高检出率给临床治疗及控制医院感染带来较大困难;糖肽类抗菌药物可作为多药耐药金黄色葡萄球菌重症感染的首选抗菌药物。

OBJECTIVE To investigate the drug-resistance of clinically isolated metieillin-resistant Staphylococcus aureus （MRSA）, and to direct rational clinic medication administration. METHODS ATB-Expression analysis system was used for identification of bacteria, then susceptibility tests were detected by K-B method. RESULTS Among 181 S. aureus isolatess, 9.5 MRSA isolatess were detected in department of gerontology with the positive rate of 73.5%） the incidence was the highest, followed by general surgery department of 69.4% and orthopedic department being 61.9%. MRSA detection rate of community-acquired infection patients was markedly lower than of hospital-acquired ones. MRSA drug-resistance rate was obviously higher than MSSA from the results of the susceptibility test. No detected isolates were resistant to vancomycin and teicoplanin. CONCLUSIONS The drug-resistance status of S. aureus is severe. The high detection rate of MRSA lays large burden for clinical treatment and controlling nosocomial infections. Glycopeptide antibiotic can be used as the first choice for multidrug resistant S. aureus infection.