耐甲氧西林金黄色葡萄球菌的临床感染特点及耐药特性

Characteristics of clinical infections caused by meticillin-resistant Staphylococcus aureus and its drug resistance

目的了解耐甲氧西林金黄色葡萄球菌(MRSA)感染状况,为有效预防与控制多药耐药菌医院感染及合理使用抗菌药物奠定基础。方法前瞻性调查方法,由医院感染专职人员定期到微生物实验室获取培养阳性结果,深入临床了解患者用药、消毒隔离措施及医务人员个人防护措施落实情况;并对临床感染资料和病原菌耐药性进行统计分析。结果 2009年11月-2010年12月共分离出126株金黄色葡萄球菌,其中86株为耐甲氧西林金黄色葡萄球菌;医院感染病例中ICU感染病例占70.83%;MRSA仅对磺胺甲噁唑/甲氧苄啶、替考拉宁、万古霉素、喹奴普汀/达福普汀有较高的敏感率,分别为93.02%、97.67%、96.51%、93.02%。结论 MRSA医院感染率有明显上升趋势,且呈多耐药性;应加强多药耐药菌的医院感染预防与控制工作,积极开展多药耐药菌的主动筛查工作,做到早发现、早隔离、早治疗;提高MRSA的治愈率,减少MRSA的医院感染和死亡率。

OBJECTIVE To investigate the infection caused by meticillin-resistant Staphylococcus aureus（MRSA） for effective prevention and control of nosocomial infection caused by multiple drug resistant bacteria and rational use of antimicrobial agents. METHODS Prospective investigation was carried out.Cultivate positive results were collected for further understanding of the medication of patients,disinfection measures and protection for medical personnel individual in clinic.And the clinical infection data and drug-resistant pathogens were obtained for statistical analysis. RESULTS In the 126 isolated strains of S.aureus from Nov.2009 to Dec.2010,86 strains were MRSA,with ICU infection accounting for 70.83% of the total nosocomial infection cases.MRSA only had high sensitivity to SMZ（93.02%）,teicoplantin（97.67%）,vancomycin（96.51%） and canute quetiapine leptin/dalfopristin（93.02%）. CONCLUSION MRSA nosocomial infection rates have significantly ascendant trend and the multiple antibiotic resistance,thus prevention and control of nosocomial infection caused by multiple drug resistant bacteria should be strengthened,and the initiative screening of multiple antibiotic resistant bacteria should be actively developed for early detection and early isolation and early treatment,so as to increase the cure rate of infection caused by MRSA and reduce the mortality.