社区感染与医院感染的耐甲氧西林金黄色葡萄球菌的耐药性分析

目的：比较社区感染耐甲氧西林金黄色葡萄球菌（MRSA）与医院感染MRSA的耐药率，了解其耐药趋势，为临床对MRSA的防治提供科学依据。方法筛选中山医科大学第一附属医院2009～2012年从各临床标本中分离出的不重复MRSA菌株，采用MicroScan PC 12或PC 20鉴定药敏复合板进行鉴定和药敏实验，参照中华人民共和国卫生部医政司医院感染监控小组制定的诊断标准，将其分为社区感染MRSA与医院感染MRSA两组，比较分析两组的耐药率。结果社区感染MRSA与医院感染MRSA的感染部位显著不同，痰、伤口分泌物是其主要标本来源。医院感染MRSA多见于痰和伤口分泌物，痰标本由2009年的30例上升到2012年的103例，伤口分泌物标本由2009年的4例上升到2012年的28例，增幅较为显著；医院感染MRSA的耐药性普遍高于社区感染MRSA，其中对环丙沙星、克林霉素、利福平的耐药性显著高于社区感染MRSA。结论医院感染MRSA的耐药性高于社区感染MRSA，社区感染MRSA的耐药率有逐年上升的趋势。

Objective To compare of community-acquired methicillin-resistant Staphylococcus aureus （MRSA） and hospital resistance rate of MRSA infection, to understand the trend of drug resistance for clinical prevention and treatment of MRSA to provide a scientiifc basis for. Method Screening hospital from 2009 to 2012 from various clinical specimens isolated from the non-repetition MRSA strains identiifed by MicroScan PC 12 or PC 20 composite plate identiifcation and drug susceptibility susceptibility test, in the light of the PRC Ministry of Health, Medical Administration hospital infection control team to develop diagnostic criteria, will be divided into community-acquired MRSA and hospital infection MRSA group, compared resistance rates were analyzed. Results Community-acquired MRSA and hospital infection MRSA is obviously different sites of infection, sputum, wound secretion is the main source of specimen;both drug resistance there are some differences. Conclusion Resistance of MRSA hospital infection than community-acquired MRSA, community-acquired MRSA resistance rates have increased year after year.