院内感染耐甲氧西林金黄葡萄球菌的耐药性分析

Resistance analysis of nosocomial infections of MRSA

目的探讨院内感染耐加氧西林金黄葡萄球菌(MRSA)的耐药性,为临床合理使用抗菌药物、控制院内感染提供依据。方法对内科2009年4月～2012年4月临床分离的375株金黄葡萄球菌的耐药性进行回顾性分析,采用标准K-B琼脂扩散法进行药敏实验和结果判断。结果 MRSA检出348株,分离率为92.80%,分离率呈逐年上升趋势;临床上以呼吸道(痰液)分离率最高,占89.08%;≥60岁患者MRSA感染率为26.56%,明显高于<60岁患者,差异有统计学意义(χ2=128.815,P<0.01);男、女患者MRSA分离率(17.04%和15.98%)差异无统计学意义(χ2=0.364,P>0.05);金黄葡萄球菌对常用抗菌药物产生了不同的耐药性,其中对青霉素G耐药率最高,达100%,对阿莫西林、环丙沙星等药物耐药率达90%以上,对万古霉素、呋喃妥因和替考拉宁敏感率为100%。结论院内金黄葡萄球菌的感染及耐药问题日益严重,需要加强耐药性监控,预防医院感染暴发流行。

Objective To discuss the drug resistance of methicillin resistant Staphylococcus aureus （MRSA） so as to provide evidence for reasonable use of antibiotics and the control over nosocomial infections. Methods A total of 375 strains of MRSA causing nosocomial infections in the department of Internal Medicine from April 2009 to April 2012 and their drug resistance were analyzed retrospectively with standard agar diffusion method. Results 348 strains of MRSA were isolated with the detection rate of 92.80/00 which had been increasing year by year; the highest detection rate which was 89.1% came from respiratory tract; the rate of MRSA infection in patients who were 60 or older was 26.6%. And there was a statistical significance between the age groups （divided at the age of 60） the patients belong to in their status of MRSA infection（x~= 128. 815, P^0.01）. No statistical significance was observed between gender groups~ S. aureus varied in drug resistance to common antibiotics. The resistance rate to penicilluin G was the highest （100%）. And the susceptibility rate to vancomycin was as high as 100%. In addition, the resistance rates to amoxicillin and ciprofloxacin reached 90.0% above.. Conclusion MRSA infections and its drug resistance become increasingly serious. It＇s neces- sary to reinforce the monitoring of the resistant strains and the prevention of the outbreak and prevalence of nosocomial in fections.