糖尿病足坏疽创面分离出的164株耐甲氧西林金黄色葡萄球菌耐药性分析

Resistance analysis of 164 strains of meticiiHn-resistant staphylococcus aureus in diabetic foot fangrene

目的分析糖尿病足坏疽（DFG）创面分离出的耐甲氧西林金黄色葡萄球菌（MRSA）的耐药性，指导临床合理应用抗生素。方法对空军总医院2008年1月至2011年12月期间610例住院DFG患者创面中分离的411株金黄色葡萄球菌，采用纸片扩散法进行药敏试验，用头孢西丁纸片扩散法筛选MRSA。结果检出的411株菌株中包括MRSA164株、甲氧西林敏感金黄色葡萄球菌（MSSA）247株，除青霉素、红霉素、克林霉素外，MSSA对其他抗生素均有较好的敏感性，而MRSA除对万古霉素、利奈唑胺、替考拉宁、呋喃妥因、氯霉素及复方新诺明敏感外，对其他抗生素均耐药。没有发现对万古霉素及利奈唑胺耐药的菌株。结论MRSA多重耐药，在DFG患者中应加强对其发生率及耐药率监测，有效地预防及控制其感染。

Objective To study the current situation of infection onset caused by methicillin-resistant staphylococcus aureus （MRSA） in diabetic foot gangrene, benefit clinical to select antibiotic for use reasonably, and prevent MRSA epidemic-outbreak. Approach the evidence for clinical prevention and cure. Methods The research was done to detect MRSA in 411 samples from patients suffering from diabetic foot gangrene in hospital which was infected by staphylococcus aureus from January 2008 to December 2011. Bacterial isolates were identi- fied by API system, the susceptibility of antibiotics was performed by Kirby-Bauer method, and Kirby-Bauer method of cefoxitin was used to select meticiUin-resistant Staphylococcus aureus MRSA. Results Of 411 strains of isolated staphylococcus aureus, 154 strains were MRSA and 247 strains were meticiUin-sensitive Staphylococ- cus aureus （MSSA）. Except for penicillin, erythromycin and clindamycin, MSSA were sensitive to the other anti- biotics. While MRSA were only sensitive to vancomycin, linezolid, teicoplanin, nitrofurantoin, chloramphenicol and trimethoprim/sulfamethoxazolen, and were resistant to all other antibiotics. No strain which was resistant to vancomycin and linezolid was isolated. Conclusions MRSA is multidrug resistant, the drug resistances of MR- SA should be monitored closely in diabetic foot gangrene to effectively prevent and control its infection.