253株金黄色葡萄球菌耐药现状分析

Antimicrobial resistance of 253 Staphylococcus aureus strains

目的了解医院金黄色葡萄球菌临床分布情况及其对常用抗菌药物的耐药率,为临床合理使用抗菌药物提供依据。方法回顾分析医院2010年5月至2011年4月检出的金黄色葡萄球菌,采用VITEK-AMS全自动微生物分析仪进行菌种鉴定和药敏分析。结果共检出金黄色葡萄球菌253株,菌株的主要来源为痰130株(51.4%)、血液39株(15.4%)、创面24株(9.5%);菌株主要科室分布前3位是神内科35株(13.8%)、ICU30(11.8%)、脑外科26株(10.3%);其中耐甲氧西林金黄色葡萄球菌(MRSA)为165株(65.2%),MRSA对多种抗菌药物耐药率>70.0%,MSSA为88株(34.8%),对除青霉素、红霉素外的大多数抗菌药物敏感,未发现耐万古霉素菌株。结论MRSA检出率高,耐药现状严重,应加强对金黄色葡萄球菌耐药性的监测,并根据药敏试验结果合理使用抗菌药物。

Objective To investigate the distribution and antimicrobial resistance of Staphylococcus aureus for the guidance of rational use of antibiotics.Methods The S.aureus from May 2010 to April 2011were analyzed retrospectively.Vitek-AMS automated system was applied to the identification and drug sensitivity test.Results A total of 253 S.aureus strains were isolated from sputum（51.4%）.The departments with the highest distribution were the neurology（29.5%）,ICU（15.8%）,and neurolsurgery（7.5%）.Among them,165（52.2%） strains were found to be MRSA,and 70.0% of these MRSA strains were found resistant to multiple antibiotics.88（47.8%） strains were MSSA which were sensitive to most of antibiotics,except penicillin and erythromycin.No strains were found resistant to vancomycin.Conclusion The isolation rate of MRSA increased significantly;the drug resistance status is very serious,indicating that it is necessary to routinely monitor MRSA occurrence and use antibiotics according to the sensitiveity tests results.