2009至2011年我院金黄色葡萄球菌耐药监测

Resistance surveillance of Staphylococcus aureus in our hospital from 2009 to 2011

目的了解我院2009年至2011年分离的金黄色葡萄球菌的临床分布及对常用抗菌药物的耐药率。方法用K-B法进行药敏试验,以CLSI 2011年判断标准分析临床分离株,用WHONET 5.5及SPSS 19.0软件统计分析。结果ICU和非ICU分离出金黄色葡萄球菌为43株和385株。ICU内金黄色葡萄球菌对β内酰胺、大环内酯、克林霉素、氟喹诺酮、氨基糖苷类耐药率均高于非ICU。ICU内金黄色葡萄球菌对头孢菌素类耐药率>72.2%。ICU和非ICU金黄色葡萄球菌对利福平均敏感率>66.7%。3年ICU内金黄色葡萄球菌的耐药率无显著变化(P>0.05)。ICU内耐甲氧西林金黄色葡萄球菌及甲氧西林敏感金黄色葡萄球菌耐药率均高于非ICU。未发现对万古霉素、替考拉宁和利奈唑胺耐药的金黄色葡萄球菌株。结论根据金黄色葡萄球菌耐药率的变迁,采取措施控制ICU内耐甲氧西林金黄色葡萄球菌的流行和指导临床用药。

Objective To investigate the clinic distribution and the re sistance of clinicial isolates of Staphylococcus aureus （SA） from Jan 2009 to Dec 2011 in our hospital. Methods Disk diffusion method was used to determine the antimicrobial susceptibility. Data were evaluated accord ing to CLSI 2011 and analyzed by WHONET 5.5 and SPSS19.0 softwares were used to analyze the data. Results Forty three isolates of S. au reus were collected from ICUs and 385 isohes from in non ICUs. S. au reus isolates from the ICU patients were more resistant against the [3 lactams, macrolides, clindamycin, fluoroquinolones and aminoglycosides than those isolates from non ICUs. The resistance rates （ 〉 72.2% ） of S. aureus to cephalosporins in ICU were higher than those in non ICUs. The sensitivity rates to rifampin were more than 66.7%. In recent 3 years, the resistance of S. aureus to the tested antimicrobials had no sig nificant difference （P 〉 0.05 ）. The S. aureus isolates resistant to vanco mycin, teieoplanin and linezolid were not found. Conclusion Analyzing the resistance alteration of the S. aureus isolates of MRSA in ICU would help to control the outbreak of MRSA in ICU and direct clinical rational use of antimicrobials.