综合医院感染金黄色葡萄球菌耐药性分析

The Drug Resistance Analysis of Staphylococcus Aureus in Different Infected Samples in General Hospitals

目的调查医院住院患者感染金黄色葡萄球菌(SAU)的耐药现状,为临床医师合理使用抗菌药物提供依据。方法对医院感染性标本中培养分离的420株SAU临床资料进行回顾性调查分析,SAU鉴定严格按照《全国临床检验操作规程》进行;药物敏感性(药敏)试验采用K-B法,结果参照美国临床实验室标准化研究所(CLSI)标准判定。结果 420株SAU检出标本以痰(64.2%)和血液(14.5%)为主;SAU感染主要分布在高压氧科、ICU、神经内科和神经外科等,MRSA检出率达75.0%;药敏试验结果显示,SAU对多种抗菌药物均不同程度耐药,仅对万古霉素和呋喃妥因敏感率为100.0%。对红霉素耐药而克林霉素敏感的59株SAU中44株(74.6%)为诱导型克林霉素耐药。结论 SAU感染率呈逐渐升高趋势,其中甲氧西林敏感金黄色葡萄球菌(MSSA)对大部分抗菌药物仍保持较好的敏感性,而MRSA表现为多药耐药性,应引起临床高度重视;检测克林霉素诱导型耐药具有重要的临床应用价值。

Objective To investigate the drug resistance of Staphylococcus aureus（SAU） in inpatients in general hospitals to provide the evidence of reasonable use of antimicrobial drugs.Methods The clinical data of the 420 SAU strains isolated from infectious specimen was retrospectively analyzed,and the identification was in accordance with the ＂National Clinical Laboratory Procedures＂.K-B method was adopted in the drug sensitivity test,and the result determination conformed to the Clinical and Laboratory Standards Institute（CLSI） standards.Results Sputum and blood were the major positive specimen of the 420 SAU strains,at the ratio of 64.2% and 14.5%.The departments of ICU,Hyperbaric Oxygen and Neurology presented the higher MRSA infectious risk,at the rate of 75.0%.Antimicrobial susceptibility test results showed that SAU was resistant to many kinds of antimicrobial drugs to different degrees,and was sensitive to vancomycin and nitrofurantoin at the rate of 100%.In 59 SAU strains,44（74.6%） were resistant to erythromycin and sensitive to clindamycin,and were inducible clindamycin resistance strains.Conclusion The infection rate of SAU increases progressively.MSSA presents good sensitivity to most antimicrobial agents,while MRSA shows multidrug resistance.To detect inducible clindamycin resistance strains may present important clinical values in the future.