ICU与非ICU金黄色葡萄球菌的耐药性分析

Analysis of drug resistance of Staphylococcus aureus in ICU and non ICU departments

目的比较ICU与非ICU金黄色葡萄球菌的耐药性,了解临床金黄色葡萄球菌感染的药敏变化,为临床合理应用抗菌药物提供科学指导。方法对2010年6月-2013年9月临床各类标本中分离出的金黄色葡萄球菌176株,对ICU 27株与非ICU 149株金黄色葡萄球菌进行比较分析,采用VITEK-32微生物分析系统进行病原菌鉴定,药敏试验采用K-B纸片法,应用SPSS 19.0软件对临床分离细菌的药敏试验结果进行统计分析。结果金黄色葡萄球菌对替考拉宁、阿米卡星、阿莫西林/克拉维酸、万古霉素等抗菌药物的耐药率较低,分别为0.18%、7.39%、10.23%、0,且ICU与非ICU差异无统计学意义,表明该地区金黄色葡萄球菌对以上抗菌药物耐药率较低,可作为治疗金黄色葡萄球菌感染的首选药物;ICU耐药率高于非ICU,差异有统计学意义(P<0.05),应根据ICU与非ICU分布特点选药。结论在临床选用抗菌药物治疗金黄色葡萄球菌感染时要根据当地细菌的耐药特点,合理选用抗菌药物,以避免抗菌药物使用不当而诱导细菌多药耐药产生,同时积极采取预防措施,防止金黄色葡萄球菌尤其是MRSA的传播、感染。

OBJECTIVE To compare drug resistance between ICU and non ICUStaphylococcus aureus,understand the sensitivity changes of clinical S.aureus infections,so as to provide scientific guidance for clinical rational use of antimicrobial agents.METHODS Among the 176 S.aureus strains isolated from Jun.2010 to Sep.2013,the27 ICU strains and the 149 ICU strains were compared,and were identified by VITEK-32 microbial analytical system,the drug susceptibility test was performed by K-B method,the result of drug sensitivity test was statistically analyzed by the software SPSS19.0.RESULTS The resistances to teicoplanin,amikacin,amoxicillin/clavulanate potassium,and vancomycin were low,being 0.18%,7.39%,10.23%,0%,and there was no significant difference between the ICU and non ICU strains（P〉0.05）,indicating that the resistance rate of S.aureusin the area was low to the above-mentioned antibacterials which can be used as drugs of first choice for treatment of S.aureus infections.Resistance in ICU was higher than that in non ICU,the difference was significance（P〈0.05）.Drug selection should be made according to ICU and non ICU distribution characteristics.CONCLUSION The clinical use of antimicrobial drugs in the treatment of S.aureus infections should be made according to the characteristics of the local bacterial resistance so as to avoid the inappropriate use of antibiotics and induction of bacterial multi drug resistance,and active preventive measures should be taken to prevent the spread of infections of S.aureus,especially MRSA.