临床不同标本分离金黄色葡萄球菌的药物敏感性

Antimicrobial susceptibility of Staphylococcus aureus isolated from dif- ferent clinical specimens

目的了解某院金黄色葡萄球菌感染分布及药物敏感性。方法对2011年1月—2012年8月该院分离的520株金黄色葡萄球菌标本来源和药敏结果进行分析。结果 520株金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌(MRSA)总检出率为23.27%(121/520),其中痰标本MRSA检出率最高,达80.82%,其次是尿液(33.33%)、血液(25.00%)、引流物标本(18.31%),皮肤组织检出率最低,仅11.38%。未发现对万古霉素和利奈唑胺耐药的金黄色葡萄球菌;金黄色葡萄球菌对万古霉素、利奈唑胺、复方磺胺甲口恶唑、呋喃妥因均较敏感。皮肤组织来源的MRSA对庆大霉素、左氧氟沙星、环丙沙星、莫西沙星、利福平、四环素的敏感率高于其他标本来源的MRSA(P<0.05);对红霉素、克林霉素敏感率低于其他标本来源MRSA(P<0.05)。MRSA对青霉素完全耐药,其中社区感染MRSA对庆大霉素、左氧氟沙星、环丙沙星、莫西沙星、利福平、四环素的敏感率高于医院感染MRSA(P<0.05);对红霉素、克林霉素、复方磺胺甲口恶唑的敏感率低于医院感染MRSA(P<0.05)。结论金黄色葡萄球菌是该院分离的重要病原菌,耐药性强,临床应根据药敏试验结果合理使用抗菌药物。

（S.aureus） isolated from a hospital.MethodsSpecimen sources and antimicrobial susceptibility test results of 520 S.aureus isolates from a hospital between January 2011 and August 2012 were analyzed.ResultsOf 520 S.aureus isolates, isolation rate of methicillinresistant S.aureus （MRSA） was 23.27%（121/520）, mainly from sputum specimen （80.82%）, followed by urine（33.33%）, blood（25.00%） and drainage（18.31%）, the detection rate was the lowest in skin and soft tissue （11.38%）. Vancomycin and linezolidresistant S. aureus was not found; S.aureus was sensitive to vancomycin, linezolid,compound sulfamethoxazole and furantoin. The sensitive rates of MRSA from skin and soft tissue to gentamycin, levofloxacin, ciprofloxacin,moxifloxacin,rifampicin and tetracycline were higher than those from the other specimen sources（P〈0.05）, but sensitive rates to erythromycin and clindamycin were lower than those from the other specimen sources（P〈0.05）. MRSA was totally resistant to penicillin, MRSA from communityassociated infection was more sensitive to gentamycin, levofloxacin, ciprofloxacin,moxifloxacin， rifampicin and tetracycline than that from healthcareassociated infection （HAI） （P〈0.05）， but susceptible rates to erythromycin, clindamycin and compound sulfamethoxazole were lower than that from HAI （P〈0.05）.ConclusionS. aureus is an important pathogen isolated from this hospital, and with high antimicrobial resistance, it is important to use antimicrobial agents rationally according to antimicrobial susceptibility test result.