医院感染产β-内酰胺酶金黄色葡萄球菌耐药性研究分析

Analysis on resistance of β-lactamase producing Staphylococcus aureus in hospital infections

目的了解医院产β-内酰胺酶金黄色葡萄球菌的分布及耐药性,以降低医院感染率。方法对2012-2013年产β-内酰胺酶金黄色葡萄球菌分布、耐药性及其导致医院感染发生率进行研究分析,应用χ2检验对数据进行统计分析。结果 2012-2013年临床送检标本中共分离出阳性菌7 285株,其中金黄色葡萄球菌检出643株,占8.8%,643株金黄色葡萄球菌中检出产β-内酰胺酶金黄色葡萄球菌413株,检出率为64.2%;产β-内酰胺酶金黄色葡萄球菌标本来源主要为痰液、伤口分泌物、血液,分别占76.5%、7.5%、6.0%;主要科室分布在重症监护病房、内分泌科、呼吸内科,分布率分别为9.2%、4.1%、12.6%;产β-内酰胺酶金黄色葡萄球菌对青霉素、红霉素、庆大霉素、四环素、亚胺培南等抗菌药物耐药率较高,分别为100.0%、88.6%、96.1%、92.3%、100.0%,对万古霉素、替考拉宁、利奈唑胺的耐药率为0;产β-内酰胺酶金黄色葡萄球菌导致医院感染发生率最多的科室为重症监护病房、呼吸内科、血液内科等。结论产β-内酰胺酶金黄色葡萄球菌易导致医院感染发生,应引起临床高度重视,临床应积极主动预防和控制医院感染的发生。

OBJECTIVE To understand the distribution and drug resistance ofβ-lactamase producing Staphylococcus aureus in our hospital so as to reduce hospital infection rate .METHODS The distribution ,drug resistance and the rate of hospital infection caused byβ-lactamase producing S .aureus were analyzed .Data were statistically analyzed with χ2 test .RESULTS Totally 7285 strains of positive bacteria were isolated from the clinical specimens delivered in 2012 to 2013 ,including 643 strains of S . aureus （8 .8% ） among w hich there w ere 413 strains of β-lactamase producing S . aureus （64 .2% ） .The specimens of β-lactamase producing S . aureus were mainly from sputum （76 .5% ） ,wound secretion （7 .5% ） ,and blood （6 .0% ） ,and were mainly distributed in departments of intensive care unit （9 .2% ） ,endocrinology （4 .1% ） and respiratory medicine （12 .6% ） .β-lactamase producing S . aureus had high resistance to penicillin （the resistance rate 100 .0% ） ,erythromycin （88 .6% ） ,gentamicin （96 .1% ） , tetracycline （92 .3% ） and imipenem （100 .0% ） ,and had 0% resistance to vancomycin ,teicoplanin and linezolid . The infection mostly occurred in the department of intensive care unit ,respiratory medicine and hematology . CONCLUSIONβ-lactamase producing S .aureus is liable to cause hospital infections w hich should be paid to close attention in clinical practice and clinicians should actively prevent and control the occurrence of hospital infections .