耐甲氧西林葡萄球菌对20种抗生素耐药谱分析

Analysis of resistance in methicillinresistant staphylococcus(MRS)to 20 antibiotics

目的了解耐甲氧西林葡萄球菌（ＭＲＳ）的感染情况及耐药特点，给临床合理选用抗菌药物有效控制ＭＲＳ的感染提供依据。方法采用苯唑青霉素纸片法和琼脂筛选法，对临床分离的葡萄球菌进行ＭＲＳ检测，并测定了它们对２０种常用抗生素的耐药谱和β内酰胺酶。结果６８株金黄色葡萄球菌（ＳＡ）中，耐甲氧西林株（ＭＲＳＡ）占３６８％，其中产β－内酰胺酶菌株占７６％。凝固酶阴性的葡萄球菌（ＣｏＮ葡菌）中，耐甲氧西林株（ＭＲＳＣｏＮ）占３８１％，其中产β内酰胺酶菌株占７１９％。ＭＲＳ菌株耐药程度明显高于甲氧西林敏感葡萄球菌。ＭＲＳＡ和ＭＲＳＣｏＮ多重耐药数分别为６～１７种和５～１４种。万古霉素、利福平、丁胺卡那对ＭＲＳ显示较强的抗菌活性。结论万古霉素是治疗感染的首选药物，ＭＲＳ的多重耐药性应引起广泛关注，需加强抗生素使用的管理和ＭＲＳ对抗生素耐药性监测。

Objective To investigate the infection rate of MRS and its characteristics in resistance so as to provide basis for clinically rational use of antimicrobial agents and effective control of MRS infections. Methods Strains of staphylococcus from clinical samples were examined by disc agar diffusion method and MRS agar plate screening.At the same time their resistance to 20 different antimicrobial agents and the presence of lactamase in the strains were measured. Results 32 strains of MRSA and 25strains of MRSCoN were identified among the strains tested,the proportion of MRSA and MRSCoN being 368% and 381% respectively.The incidence of MRSA and MRSCoN producing lactamase was 76%and 719%respectively.The resistance rate showed significant differences between the MRS and MSS.Multiresistance ranged from 6 to 17 and 5 to 14 antibiotics in MRSA and MRSCoN.Vancomycin,rifampin and Amikacin had effective antibacterial activity against MRS. Conclusion Vancomycin is the first choice among antibiotics for MRS infections. Wide attention should be paid to the multiresistance of MRS,the use of antibiotics should be better managed and the resistance of MRS to antibiotics should be further monitored.