耐甲氧西林金黄色葡萄球菌6年发生率及耐药性分析

Incidence and drugs-resistance of clinically isolated methicillin-resistant Staphylococcus aureusin 6 years

目的探讨昆明市第一人民医院2002年1月至2007年6月耐甲氧西林金黄色葡萄球菌(MRSA)临床发生率及耐药性变迁的状况。方法用Microscan Walkaway40鉴定系统及传统手工方法鉴定细菌。采用K-B纸片扩散法进行药物敏感试验,采用WHONET5.3软件进行耐药性数据分析。结果 MRSA临床分离率呈逐年上升趋势,其中2004年发生率最高(90.1%),该年在ICU病房和神经外科有MRSA暴发流行现象。各种检出MRSA的标本中,痰液标本比例最大(86.2%)。老年患者和男性患者为易感人群。万古霉素(VAN)、替考拉宁(TEC)的耐药率为0.0%;米诺环素(MNO)、复方新诺明(SXT)的耐药率低于20%;四环素(TCY)的耐药率低于40%;氯霉素(CHL)的耐药率在60%以上;其他抗菌药物的耐药率都在80%以上。结论该院MRSA发生率呈逐年上升趋势,ICU、神经外科易暴发流行,并呈现多重耐药性。

Objective To study drugs-resistance of clinically isolated strains of methicillin-resistant Staphylococcus aureusfrom the first people hospital of Kunming during Jan. 2002 to Jun. 2007. Methods Bacterial identification was tested by MicroScan WalkAway 40 and conventional bacterial identification assay system. The drugs susceptibility was tested with K-B method recommended by WHO. WHONET 5.3 software was applied for statistics. Results The MRSA isolated incidence showed an increasing trend within these years. Especially in 2004 the MRSA isolated incidence was the maximum and there were the datas of outbreak popular in intensive care unit and neurosurgery. The antibiotic resistance rate of MRSA strains to VAN, TEC, MNO, SXT, TCY, CHL and other antibiotics was 0,0, 〈 20 %, 〈 20 %, 〈 40 %, 〉 60 % and 〉 80 %. MRSA-detection rate in intensive care unit and neurosurgery unit was higher than the average level. The detective rate of MRSA sputum was highest,accounting for 86.2%. Susceptible population mainly involved in elderly patients and male patients. Conclusion The MRSA isolated incidence showed an upward trend within these years, Neurosugery and ICU were suffered from MRSA infection easily. Mult-drug resistance is one important characteristic of MRSA.