2009年MRSA的临床分布和耐药性特征

Clinical distribution and drug resistance of MRSA to antibiotics in 2009

目的对海南省农垦总医院2009年金黄色葡萄球菌（Staphylococcus aureus MRSA）的临床分布情况和耐药性进行分析,指导临床合理使用抗生素。方法收集该院2009年1月~12月临床分离的MRSA,利用微生物分析系统进行细菌鉴定和药敏试验。结果共分离出MRSA132株,占金黄色葡萄球菌的40.49%,主要分布在门诊（18.98%）,ICU病房（14.39%）,神经内科（13.64%）,呼吸内科（12.88%）。感染标本以痰液（59.54%）为主;所有MRSA株对万古霉素都敏感,对苯唑西林、青霉素、美罗培南、拉氧头孢、哌拉西林/他唑巴坦都耐药,对红霉素、环丙沙星、诺氟沙星、克林霉素、四环素、庆大霉素、利福平、呋喃妥因耐药率分别为91.70%、81.10%、80.30%、78.80%、69.70%、68.90%、53.00%和19.70%。结论 MSRA的感染率高,耐药现象严重。

Objective To analyze the clinical distribution and drug resistance of MRSA in Hainan Provincial Nongken Hospital in 2009.Mothods The 132 clinical isolates of MRSA in the hospital from January to December,2009 were collected.MRSA and susceptibility were determined with DL-96 analysis system.Results There 132 isolates were identified MRSA（40.85%,132/323）.All the strains distributed mainly from outpatient department,ICU,neurology and respiratory wards accounted for 18.98%,14.39%,13.64% and 12.88% respectively.59.54% of the MRSA were islaoted from sputum samples.MRSA isolates were susceptible to vancomycin.However,all strains were resistant to oxacillin,penicillin,meropenem,latamoxef and piperacillin/tazobactam.Resistance rates to erythromycin,ciprofloxacin,norfloxacin,clindamycin,tetracycline,gentamicin,rifampicin,and nitrofurantoin were 91.7%,81.1%,80.3%,78.8%,69.7%,68.9%,53%,and 19.7% respectively.Conclusions The infection and drug resistance of MRSA were serious and the strains were multiple resistant.