感染性葡萄球菌的分布及耐药性分析

Analysis on the Distribution and Drug Resistance of the Infectious Staphylococcus

目的了解2009年新乡市中心血站感染标本中葡萄球菌的分布及耐药性。方法从住院和门诊就诊患者各类感染标本中分离出葡萄球菌506株,用VITEK-32型全自动微生物分析仪进行细菌鉴定,用琼脂纸片扩散(K-B)法进行药敏试验。结果感染标本中检出的葡萄球菌中,金黄色葡萄球菌占52.4%,其中,耐甲氧西林金黄色葡萄球菌(MRSA)为54.3%,住院患者的金黄色葡萄球菌中MRSA占64.3%,门诊患者的MRSA占20.6%,尿标本的金黄色葡萄球菌中MRSA检出率最高(83.3%)。凝固酶阴性葡萄球菌(CNS)中耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率为85.6%,住院患者CNS中MRCNS占90.8%,门诊患者MRCNS占62.2%,来自血液标本的CNS中MRCNS检出率最高(90.0%)。CNS的分布以表皮葡萄球菌为主(46.5%)。MRSA对-内酰胺类,喹诺酮类,大环内酯类,氨基糖苷类和四环素有很高的耐药率,均达80.0%以上。MRCNS除氯霉素及利福平外,对所测抗菌药物耐药率均在50.0%以上。结论标本来源不同,葡萄球菌的分布也不同。葡萄球菌耐药率有所上升,对不同抗菌药物耐药性有较大差异。

Objective To analyze the distribution and drug resistance of staphylococcus in 2009 in our blood station.Methods Five hundred and six isolates of staphylococcus were isolated from various types of specimens of patients infected,which were treated with VITEK-32 automatic analyzer to identify microbial identification of bacteria,and with K-B method to test drug sensitivity.Results In the staphylococcus infected,staphylococcus aureus accounted for 52.4%,among which,methicillin-resistant staphylococcus aureus（MRSA） was 54.5%;the MRSA of staphylococcus isolated from hospital inpatients accounted for 64.3%,outpatients MRSN accounted for 20.6%;the highest detection rate of MRSA of staphylococcus aureus was from urine specimens,accounting for 83.3%.Methicillin-resistant coagulase-negative staphylococci（MRCNS） of coagulase-negative staphylococci（CNS） accounted for 85.6%;MRCNS of CNS isolated from patients accounted for 90.8%,MRCNS of outpatients accounted for 62.2%;and the highest detection rate of MRCNS of CNS was from blood,accounting for 93.0%.CNS was mainly distributed with staphylococcus epidermidis（46.5%）.MRSA had a high rate of resistance,with over 80.0% to-lactams,quinolines,macrolides,aminoglycosides and tetracycline.The drug resistance of MRCNS was more than 50.0% excluded chloramphenicol and rifampin.Conclusion As to the different sources of specimens,the distribution of staphylococcus was different.The rate of staphylococcus aureus resistance increased,and there was a great difference to the different antimicrobial agents.