肿瘤专科医院金黄色葡萄球菌的分布与耐药性分析

Distribution and drug resistance of Staphylococcus aureus strains isolated from a cancer hospital

目的了解肿瘤专科医院金黄色葡萄球菌及耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及耐药性,为临床合理使用抗菌药物提供依据。方法分析2009-2013年肿瘤专科医院住院肿瘤患者分离到的424株金黄色葡萄球菌的感染情况及耐药性,并用WHONET5.6软件进行统计分析。结果 424株金黄色葡萄球菌中检出MRSA170株,占40.1%;金黄色葡萄球菌主要分离于呼吸道、引流液和分泌物,分别占49.1%、18.2%和13.9%;MRSA在ICU的检出率最高,为72.6%;MRSA对万古霉素和利奈唑胺100.0%敏感,对其他抗菌药物均有不同程度的耐药;甲氧西林敏感金黄色葡萄球菌(MSSA)对青霉素耐药率>80.0%,对其他多种药物敏感,耐药率<30.0%。结论肿瘤医院金黄色葡萄球菌具有多药耐药性,应加强MRSA的监测,为临床合理使用抗菌药物提供依据。

OBJECTIVE To understand the clinical distribution and drug resistance of the Staphylococcus aureus and methicillin-resistant Staphylococcus aureus（MRSA）strains isolated from a cancer hospital so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 424 strains of S.aureus were isolated from the tumor patients who were hospitalized the cancer hospital from 2009 to 2013,then the incidence of infection and drug resistance were observed,and the statistical analysis was performed with the use of WHONET5.6software.RESULTS Totally 170 strains of MRSA were detected among the 424 strains of S.aureus,accounting for 40.1%.Among the isolated S.aureus strains,49.1% were isolated from respiratory tract,18.2% from drainage fluid,13.9%from secretions.The isolation rate of MRSA was highest in the ICU（72.6%）.The drug susceptibility rates of the MRSA isolates to vancomycin and linezolid were 100.0%,and the strains varied in the drug resistance to other antibiotics;the drug resistance rate of the methicillin-susceptible S.aureus（MSSA）isolates to penicillin was more than 80.0%,and the strains were susceptible to a variety of other antibiotics,with the drug resistance rate less than 30.0%.CONCLUSIONThe S.aureus strains isolated from the cancer hospital are multidrug-resistant.It is necessary to strengthen the surveillance of the MRSA isolates so as to provide guidance for reasonable clinical use of antibiotics.