痰标本中金黄色葡萄球菌的耐药性监测

Antibiotic resistance of the Staphylococcus aureus strains isolated from sputum

目的回顾性分析痰标本中金葡菌的临床分布和耐药情况,为制订预防控制措施提供依据。方法对2009年1月至2012年9月临床分离的276株金葡菌进行分析,细菌鉴定采用VITEK 2 Compact全自动细菌培养鉴定仪,药敏试验结果按CLS1标准判断。结果耐甲氧西林金葡菌(MRSA)的检出率为79.0%(218/276);临床分离的金葡菌主要分布为神经内科76株(27.5%)、ICU 70株(25.4%)、神经外科50)株(18.1%)、呼吸内科25株(9.1%)。金葡菌对万古霉素、替考拉宁和奎奴普丁-达福普汀的耐药率均<0.5%;MRSA对甲氧苄啶-磺胺甲噁唑的耐药率低于甲氧西林敏感金葡菌(MSSA);MRSA对其他大多数抗菌药物的耐药率高于MSSA。结论 MRSA的检出率和耐药率较高,临床应依据药敏试验结果合理选择抗菌药物。

Objective A retrospective analysis was conducted to review the distribution and antibiotic resistance in the Staphylococcus aureus strains isolated from sputum and provide evidence for effective prevention and control of infections.Methods The 276 strains of S.aureus isolated during the period from January to September of 2009 were included in this analysis.The isolates were identified and tested for susceptibility using VITEK 2 Compact Automatic Culture and Identification System.Results The prevalence of methicillin-resistant S.aureus（MRSA） was 79.0%（218/276）.The S.aureus strains were mainly isolated from Department of Neurology（27.5%.76/276）,ICU（25.4%,70/276）,Neurosurgery（18.1%,50/276）,and Respiratory Medicine（9.1%.25/276）.Vancomycin,teicoplanin and quinupristin-dalfopristin were the most active agents against these S.aureus.The resistant strains were less than 0.5%.MRSA showed lower resistance rate to trimethoprim-sulfamethoxazole than MSSA.MRSA strains were more resistant than MSSA to most other antibacterial agents.Conclusions The MRSA isolates from sputum are highly prevalent and resistant to antibiotics.Antimicrobial agents should be selected appropriately according to the results of susceptibility testing.