耐甲氧西林金黄色葡萄球菌的感染分布及耐药分析

Distribution and drug resistance of methicillin-resistant Staphylococcus aureus infections

目的了解临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)感染分布及耐药性特点,为合理使用抗菌药物提供依据。方法对医院2010年各类标本中分离的金黄色葡萄球菌进行回顾性分析,用PCR检测mecA基因确证MRSA。结果 2010年共分离出金黄色葡萄球菌122株,其中MRSA 79株,占64.75%,主要分布于ICU、骨科、老年病科,主要来源于痰和创面分泌物,分别占70.98%和22.78%;79株MRSA对万古霉素、利奈唑烷、呋喃妥因和磺胺甲噁唑/甲氧苄啶的耐药率分别为0、0、17.72%和18.99%,对其他种类抗菌药物耐药率均>75.00%,且耐药率均高于甲氧西林敏感金黄色葡萄球菌(MSSA)。结论临床分离的金黄色葡萄球菌中MRSA检出率较高,对多种抗菌药物耐药率高,且多为多药耐药,临床应根据药敏结果合理选择抗菌药物,减低耐药菌株的产生。

OBJECTIVE To investigate the distribution and drug resistance of methicillin resistant Staphylococcus aureus（MRSA） causing infections and to provide the basis for the rational use of antibacterial agents.METHODS A retrospective analysis of S.aureus that isolated from the specimen in 2010 was performed.MRSA was confirmed by mecA gene with PCR.RESULTS A total of 122 strains of S.aureus were isolated in 2010,there were 79 strains of MRSA（64.75%）,which mainly distributed in the ICU,orthopedics department,and department of geriatrics;the sputum and wound secretions were the main specimens resources,accounting for 70.89% and 22.78%,respectively;the drug resistance rates of the 79 strains of MRSA to vancomycin,linezolid,nitrofurantoin,and sulfamethoxazole/trimethoprim were 0,0,17.72%,and 18.99%,respectively,the drug resistance rates to other antibiotics were higher than 75.00%,which were higher than those of the methicillin-sensitive S.aureus（MSSA）.CONCLUSION The detection rate of MRSA is high among the clinical isolates of S.aureus,the MRSA strains are serious multidrug-resistant.It is necessary for the hospital to reasonably use antibiotics according to the drug susceptibility testing result so as to reduce the drug resistant strains.