骨科感染葡萄球菌属细菌临床分布与耐药性分析

Clinical distribution and drug resistance of Staphylococcus in orthopedic infections

目的分析骨科感染葡萄球菌属细菌的分布及耐药性,为临床治疗合理选用抗菌药物提供依据。方法对贵阳医学院第三附属医院2012年1月至2014年7月从骨科感染标本中分离出的葡萄球菌属细菌进行比较分析,微生物病原菌鉴定按照《全国临床检验操作规程》进行,药敏试验采用K-B纸片法,结果判断按美国临床和实验室标准化协会(CLSI)的标准,应用SPSS 19.0软件对结果进行统计分析。结果分离出葡萄球菌属细菌178株,其中皮表葡萄球菌93株,占52.25%,金黄色葡萄球菌81株,占45.51%;两种细菌对阿莫西林/克拉维酸、红霉素、头孢克洛、罗红霉素、氧氟沙星等耐药率分别为19.51%、0%,74.70%、39.44%,45.71%、8.33%,75.76%、44.44%,45.83%、10.00%。骨科感染表皮葡萄球菌耐药率明显高于金黄色葡萄球菌感染(P<0.05)。结论骨科皮表葡萄球菌的感染率与耐药率不断上升,耐药率明显高于金黄色葡萄球菌,应当引起骨科临床重视。

Objective To analyze the distribution and drug resistance of Staphylococcus bacteria from orthopedic infections,and provide basis for rational use of antimicrobial agents. Methods The Staphylococcus bacteria isolated from orthopedic infections in our hospital from January 2012 to July 2014 were analyzed. The pathogen identification was conducted in accordance with the National Clinical Laboratory Procedures. Susceptibility test was performed using K-B paper method and the results were evaluated by CLSI standards. SPSS 19. 0 was used for data analysis. Results 178 strains of Staphylococcus bacteria were isolated,including 93 strains of Staphylococci epidermidis（ 52. 25%） and 81 strains of Staphylococcus aureus（ 45. 51%）. The resistance rates of the two bateria to Amoxicillin / clavulanic acid, Erythromycin, Cefaclor, Roxithromycin and Ofloxacin were 19. 51% vs 0%,74. 70% vs 39. 44%,45. 71% vs 8. 33%,75. 76% vs 44. 44%,and 45. 83% vs 10. 00%,respectively. The resistance rate of Staphylococcus epidermidis was significantly higher than that of Staphylococcus aureus（ P〈0. 05）.Conclusion The rate of orthopedic infections by Staphylococci epidermidis and the pathogen＇ s resistance rate are rising and significantly higher than Staphylococcus aureus,which should be paid more attention in clinical practice.