山西临汾地区耐甲氧西林金黄色葡萄球菌临床分布及耐药性分析

Distribution and antibiotic resistance of methicillinJ-resistant staphylococcus aureus in Linfen district of Shanxi

目的了解山西临汾地区临床标本分离出的耐甲氧西林金黄色葡萄球菌(MRSA)临床分布及对常用抗菌药物的耐药性,为临床合理应用抗生素提供参考依据。方法 API系统鉴定细菌,用MIC法ATBSTAPH5板条进行药物敏感分析,MRSA用头孢西丁纸片扩散法(K-B法)筛选,用WHONET 5.4软件进行统计学分析。结果共检出金黄色葡萄球菌137株,其中MRSA 59株,MRSA的平均检出率为30.1%。MRSA主要分布在重症监护病房(35.6%)和神经外科(18.6%)。感染标本以痰(59.3%)、伤口分泌物(32.2%)为主。MRSA对β-内酰胺类、大环内酯类、喹诺酮类、氨基糖苷类、林可霉素、四环素的耐药率均>80%,但对复方磺胺甲(口恶)唑敏感率高(84.8%)。未发现对万古霉素、替考拉宁、达福普汀和呋喃妥因耐药的菌株。结论临汾地区金黄色葡萄球菌中MRSA分离率低,MRSA耐药严重且呈多重耐药。

Objective To study the clinical distribution and antibiotic resistance of methicillin-resistant staphylococcus aureus （MRSA） from Linfen district for providing reference to clinical rational use of antibiotics. Methods Bacterial isolates were identified by API system. The antibiotic susceptibility of the isolates were performed by ATB Staph5 Stips with MIC method and the Kirby-Bauer method of cefoxitin was used to select MRSA. WHONETS. 4 software was used to analyze the data. Results Among 196 strains of staphylococcus aureus, 59 MRSA strains were isolated. The prevalence of MRSA was 30.1%. Of all the MRSA isolates, 36 were collected from ICU （35.6%）, 19 from Neurosurgery （18.6%）,etc. Most of the MRSA strains were isolated from sputum （59.3M） and the others from wound secretions （32.2%）, etc. MRSA was resistant to more 90% of the β- lactan,macrolides, quinolones, aminoglycosides, gentamicin, clindamycin, tetracycline, but quite sensitive to SMZ （84.8%）. No strains resistant to vancomycin,teicoplanin,Q. D and nitrofurantion were found yet. Conclusions The isolating rate of MRSA from Staphylococcus aureus in Linfen was lower. MRSA has higher antibiotic resistant rate and more serious multi-drug resistance.