2009—2011年浙江省富阳市人民医院金黄色葡萄球菌的感染分布和耐药性调查

Distribution and drug resistance of Staphylococcus aureus isolates in Fuyang People's Hospital Zhejiang,2009-2011

目的分析浙江省富阳市人民医院2009—2011年临床分离的金黄色葡萄球菌的感染分布、耐药情况和检测克林霉素诱导型耐药的发生率,为临床正确选择抗菌药物提供依据。方法用常规细菌培养方法从患者标本中分离出细菌,法国ATB细菌仪鉴定菌种,采用K-B纸片法检测抗菌药物的敏感性,按照CLSI推荐的D试验方法检测分析红霉素对克林霉素诱导耐药情况。结果 2009—2011年共分离出225株金黄色葡萄球菌,分离率最高为痰及支气管吸出物,占65.8%,其次为脓液,占14.2%。以重症监护室、呼吸内科和骨科为多见。未发现对万古霉素耐药的菌株,耐甲氧西林金黄色葡萄球菌(MRSA)共检出108株,D试验阳性率为65.5%。结论金黄色葡萄球菌感染以呼吸道为主,其次为脓液。对各种抗菌药物除万古霉素外均出现了不同程度的耐药。克林霉素诱导型耐药发生率很高。应加强金黄色葡萄球菌耐药性的监测与控制,常规检测D试验,指导临床合理使用抗菌药物。

Objective To understand the distribution and drug resistance of Staphylococcus aureus strains isolated in Fuyang People＇ s Hospital, Zhejiang province, from 2009 to 2011, and provide evidence for the rational use of antibiotics. Methods S. aureus strains were isolated from the clinical samples collected from the patients in our hospital and identified with ATB . The drug susceptibility test of the strains was conducted by using K-B method. D-test recommended by CLSI was conducted to detect erythromycin induced clindamycin resistance. Results A total of 225 S. aureus strains were isolated during this period. The isolation rate in sputum or bronchial aspirate was highest （65.8%）, followed by liquor puffs （14. 2% ）. The clinical samples were mainly taken in ICU, respiratory disease department and orthopedics department. No vancomycin resistant strains were detected. Totally 108 strains were methicillin resistant Staphylococcus aureus （MRSA）. The positive rate of D-test was 65.5%. Conclusion S. aureus was mainly detected in respiratory samples, followed by liquor puffs. The strains were resistant to commonly used antibiotics at different levels except vancomycin. The induced clindamycin resistance was serious. It is necessary to strengthen the surveillance and control of the drug resistance of S. aureus, and use D-test routinely to guide the rational use of antibiotics in clinical treatment.