耐甲氧西林金黄色葡萄球菌的院内分布及耐药分析

Methicillin-resistant staphylococcus aureus nosocomial distribution and drug resistance

目的研究我院耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布状况及耐药特点。方法 MRSA检测采用头孢西丁纸片法,药敏试验采用K-B纸片扩散法,临床分布调查采用病历资料回顾性统计。结果我院MRSA检出率为52.25%,临床分布占比最高的科室为呼吸内科25.93%,标本来源为呼吸道分泌物45.68%,患者年龄以60岁以上老年人为主56.79%。对抗生素的耐药率分别为:青霉素100%、头孢唑啉100%、头孢呋辛90.12%、头孢噻肟76.54%、四环素98.77%、红霉素97.53%、克林霉素90.12%、对替考拉宁、万古霉素均无耐药。结论 MRSA的耐药率显著高于甲氧西林敏感金黄色葡萄球菌(MSSA),且呈现多重耐药性,对重症MRSA感染可选用替考拉宁、万古霉素治疗。

Objective To study hospital methicillin-resistant Staphylococcus aureus（MRSA） clinical distribution and characteristics of drug resistance.Methods MRSA were detected by cefoxitin disk diffusion method,antimicrobial susceptibility was tested by Kirby-bauer method,Clinical distribution surveyed by medical records retrospectively.Results The detection rate of MRSA in our hospital 52.25%,the highest proportion of the clinical distribution was respiratory medicine department 25.93%.The highest proportion of specimens from the respiratory secretions 45.68%.The highest proportion of patients aged 60 years or older accounted for 56.79%.Resistance to antibiotics were：penicillin 100%,Cefazolin 100%,Cefuroxime 90.12%,Cefotaxime 76.54%,Tetracycline 98.77%,97.53% to Erythromycin,Clindamycin 90.12%,Teicoplanin vancomycin resistance were not.Conclusion The resistance rate of MRSA was significantly higher than methicillin-sensitive staphylococcus aureus（MSSA）,and showed multiple drug resistance,Teicoplanin,Vancomycin can be used for treatment of severe MRSA infections.