168株金黄色葡萄球菌的临床分布与耐药分析

The clinical distribution and drug resistance analysis of 168 Staphylococcus aureus isolated strains

目的了解该院金黄色葡萄球菌的临床分布特点及耐药情况,指导临床合理用药,减少耐药菌株的产生。方法对临床送检的合格标本进行细菌培养,采用VITEK-2Compact全自动微生物分析系统进行鉴定和药物敏感试验。结果从各类标本中分离出金黄色葡萄球菌168株,其中耐甲氧西林的金黄色葡萄球菌(MRSA)59株,检出率为35.1%(59/168),分离的金黄色葡萄球菌标本主要来源于分泌物51.2%(86/168)、痰液22.0%(37/168)、全血5.4%(9/168)、置管液5.4%(9/168)。MRSA分布的科室以神经科(30.5%)、普外泌尿科(22.0%)、骨科(15.2%)、心胸外科(8.5%)、呼吸科(8.5%)多见。对MRSA和非耐甲氧西林的金黄色葡萄球菌(MSSA)耐药率为0的抗菌药物有万古霉素、利奈唑胺、替考拉宁、奎努普汀/达福普汀、呋喃妥因,青霉素、复方磺胺甲噁唑对MRSA的耐药率分别为100%、6.8%,对MSSA的耐药率分别为91.7%、12.8%,其余9种抗菌药物对MRSA的耐药率均高于MSSA。结论加强耐药菌株的监测,规范临床用药,有利于控制感染。

Objective To understand the hospital clinical distribution and drug resistance of Staphylococcus aureus, so as to guide clinical rational drug use and to reduce the generation of drug-resistant strains. Methods Bacteria culture, identification and drug sensitive test of qualified clinical specimens were processed by VITEK 2 Compact automatic microbial analysis system. Results 168 strains of Staphylococcus aureus were isolated from all the specimens,including 59 strains of methicillin-resistant Staphylo- coccus aureus （MRSA） with the detection rate of 35.1 % （59/168）. The isolated strains of Staphylococcus aureus mainly came from secretion specimens[51.2%（86/168）],sputum[22.0% （37/168）],whole blood [5.4% （9/168）],and catheter liquid [5.4%（9/ 168） ]. MRSA mainly distributed in departments of neurological （ 30.5 % ）, general urologist （ 22.0 % ）, orthopedic （ 15.2 %）, cardio- thoracic surgery（8.5% ） ,and respiratory（8.5 %）. The durg resistant rates of MRSA and non-methicillin-resistant Staphylococcus aureus （MSSA） were zero to vancomycin,linezolid, teicoplanin, quinupristin/dalfopristin and furantoin. The drug resistant rates of MRSA to penicillin and compound sulfamethoxazole were 100.0% and 6.8% respectively,and which were 91.7% and 12.8% re- spectively in MSSA. MRSA had higher drug resistant rates to the other nine kinds of antimicrobial drugs than MSSA. Conclusion It is helpful for infection controlling to enhance drug resistant strain monitoring and standarding clinical medication.