耐甲氧西林金黄色葡萄球菌的耐药性分析

Drug resistance of methicillin-resistant Staphylococcus aureus

目的了解耐甲氧西林金黄色葡萄球菌临床感染现状及其耐药性,为临床合理使用抗菌药物提供科学依据。方法采用phonix-100对314株金黄色葡萄球菌进行鉴定和药敏试验,数据统计使用WHONET5.5软件及SPSS17.0软件进行。结果共分离出314株金黄色葡萄球菌,其中耐甲氧西林金黄色葡萄球菌(MRSA)164株,占52.2%,甲氧西林敏感金黄色葡萄球菌(MSSA)150株,占47.8%;标本来源以痰液为主,占58.3%,其次是伤口分泌物占29.3%;MRSA和MSSA对万古霉素、替考拉宁、利奈唑胺无耐药,MRSA对阿米卡星、庆大霉素、妥布霉素、利福平、环丙沙星、磺胺甲噁唑/甲氧苄啶、克林霉素、红霉素、四环素耐药率分别为86.6%、89.6%、93.3%、43.3%、87.8%、6.7%、84.1%、84.1%、85.3%;MSSA对青霉素、阿米卡星、庆大霉素、妥布霉素、利福平、环丙沙星、磺胺甲噁唑/甲氧苄啶、克林霉素、红霉素、四环素耐药率分别为92.0%、0.7%、32.7%、32.7%、2.7%、10.0%、34.7%、36.0%、59.3%、22.0%;MRSA对大环内酯类、氨基糖苷类、氟喹诺酮类、四环素类、克林霉素耐药率明显高于MSSA。结论 MRSA分离率较高,耐药性严重,应引起重视,临床应根据药敏试验结果合理选择抗菌药物。

OBJECTIVE To analyze the incidence and resistance of methicillin-resistant Staphylococcus aureus（MRSA）so as to provide evidence for the reasonable clinical use of antibiotics.METHODS The identification and antimicrobial susceptibility testing were performed with Phoenix-100.Statistical analysis was carried out with WHONET 5.5and SPSS17.0.RESULTS Totally 314strains of Staphylococcus aureus were isolated,including 164（52.2%）MRSA and 150（47.8%）methicillin-sensitive S.aureus（MSSA）;sputum was the highest in the distribution of 58.3%,the next was secretion,accounting for 29.3%;MRSA and MSSA were highly susceptible to glycopeptides and linezolid.The drug resistant rates of MRSA to amikacin,gentamicin,tobramycin,rifampicin,ciprofloxacin,sulfamethoxazole-trimethoprim,clindamycin,erythromycin,tetracycline were 86.6%,89.6%,93.3%,43.3%,87.8%,6.7%,84.1%,84.1%,and 85.3%respectively.The drug resistant rates of MSSA to penicillin,amikacin,gentamicin,tobramycin,rifampicin,ciprofloxacin,sulfamethoxazole-trimethoprim,clindamycin,erythromycin,tetracycline were 92.0%,0.7%,32.7%,32.7%,2.7%,10.0%,34.7%,36.0%,59.3%,and 22.0%,respectively.The drug resistance rates of MRSA strains to macrolides,aminoglycosides,quinolones,tetracyclines,and clindamycin were significantly higher than that of MSSA.CONCLUSION The isolation rate of the MRSA is high,and the strains are highly drug resistant,which should attach great importance to.It is necessary to reasonably use antibiotics based on the result of drug susceptibility testing.