金黄色葡萄球菌的临床分布与耐药性变迁

Clinical distribution of Staphylococcus aureus strains and their resistance to antibiotics

目的:分析2009～2011年临床分离的金黄色葡萄球菌(SAU)在科室的分布情况和耐甲氧西林金黄色葡萄球菌(MRSA)检出率。比较MRSA和甲氧西林敏感金黄色葡萄球菌(MSSA)耐药性及变迁情况。为临床合理用药和控制MRSA医院感染提供有效依据。方法:采用VI TEK-2全自动微生物分析仪进行细菌鉴定和药敏试验。采用WHONTE5.5和SPSS13.0软件对数据进行统计分析。结果:共检出金黄色葡萄球菌332株(MRSA85株、MSSA247株),2009年、2010年～2011年临床分离金黄色葡萄球菌分别为98株、101株、133株,其中MRSA检出率分别为24.5%、27.7%、24.8%。MRSA感染以肿瘤科、骨科、I CU和胸外科患者居多。MRSA在脓液、痰、分泌物分离率较高。332株金黄色葡萄球菌对万古霉素、利奈唑胺和替考拉宁的敏感率均为100%,除以上三种药物和青霉素外,MRSA和MSSA对其他13种抗菌药物的耐药性差异均有统计学意义(P<0.05)。结论:三年间MRSA的检出率变化趋势不明显,差异无统计学意义(P>0.05)。未发现VI SA株和VRSA株。我院已建立较为完善的MDRO监测和院感控制制度,严格控制广谱抗生素的应用,严格执行消毒隔离措施,有效的预防了MRSA耐药率的提高和院内传播。

Objective The aim of our study was to investigate the distribution of Staphylococcus aureus strains isolated from different departments in XL hospital during 2009 to 2010. The resistance to antibiotics of MRSA and MSSA and the changes were also compared. Methods Pathogens and Bacterial resistance to antibiotics were identified using the VITEK 2 Compact equipment. Data were got from WHONTE5.5 and analyzed by SPSS13.0. Results There were 332 Staphylococcus aureus strains were detected （MRSA 85 strains,MSSA 247 strains）,represented by 98 strains in 2009, 101 strains in 2010 and 133 strains in 2011. The rate of MRSA was 24.5%,27.7%,24.8% from 2009 to 2010.MRSA was mainly found in the department of oncology,orthopaedics, ICU and chest surgery~ MRSA was mainly isolated from pus, sputum and secretion. The 332 Staphylococcus aureus strains showed high sensitive to vancomycin,linezolid and teicoplanin, the sensitive rate was 100%. There were significant differences （P〈0.05）of their resistance to other 13 antibiotics, except vancomycin,linezolid ,teicoplanin and penicillin. Conclusion The changes of MRSA detection rate in three years was not significant （P〉0.05）. VISA and VRS were not found. We have established MDRO detection and the prevalence of MRSA was controlled in our hospital.