耐甲氧西林葡萄球菌的临床感染特点及耐药性分析

Characteristics of clinical infection caused by meticillin-resistant staphylococci and drug resistance

目的探讨医院耐甲氧西林金黄色葡萄球菌(MRSA)及耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的临床感染特点及其耐药性,为临床治疗葡萄球菌属感染提供正确选药依据。方法对2008年1-12月从医院各临床科室送检的各类标本中分离鉴定出的MRSA及MRCNS,采用K-B法,进行15种抗菌药物的药敏试验,对其药敏结果进行统计及分析,并探讨其临床感染与耐药特点。结果所分离出263株金黄色葡萄球菌中,MRSA有193株,占73.4%,以ICU为最多,其阳性检出率为93.4%,其次分别为烧伤科及呼吸内科,阳性检出率分别为91.9%及69.2%;92株凝固酶阴性葡萄球菌中,MRCNS有64株,占69.6%,以烧伤科最多,其阳性检出率为90.9%,其次分别为ICU和心外科,其阳性检出率分别为86.7%和76.9%;MRSA和MRCNS均对大环内酯类、氨基糖苷类、喹诺酮类、磺胺类等抗菌药物呈多药耐药性;未发现耐万古霉素菌株。结论及时了解MRSA、MRCNS感染的分布与特征、监测其耐药情况,有助于临床及时采取合理的防治措施,有效控制感染及扩散。

OBJECTIVE To investigate the characteristic of clinical infection and drug resistance of methicillin resistant Staphylococcus aurous and methicillin resistant coagulates-negative Staphylococci and provide guidance for rational use of antibiotics.METHODS Totally 15 kinds of antibiotics were carried out drug sensitivity tests for MRSA and MRCNS isolated from different kinds of specimens from Jan to Dec 2008.Drug resistance test was performed by K-B method.RESULTS In 263 isolated strains of S.aureus,193 strains（73.4%） were MRSA,The strains isolated from the departments were as the follows：ICU（93.4%）,Department of burn（91.9%）,Department of respiratory internal medicine（69.2%）.In 92 strains of coagulates-negative Staphylococci,64 strains（69.6%） were MRCNS,The detection rate and positive rate were predominant in Department of burn（90.9%）;Department of ICU（86.7%）;Department of cardiac surgery（76.9%）.MRSA strains and MRCNS were multi-drug resistant to microclines,amino glycosides,quinolones,fluoroquinolones,sulfanilamides,and so on.No vancomycin-resistant S.aureus（VRSA） was found.CONCLUSION It is important to understand the distribution and characteristic of MRSA and MRCNS,and monitoring the drug resistance can help to take the reasonable measures for prevention and control of hospital infection.