2011～2014年某院CR-AB及MRSA菌株的临床分布及耐药分析

Distribution and drug resistance analysis of CR-AB and MRSA from 2011 to 2014

目的了解该院医院感染致病原中耐碳青霉烯鲍曼不动杆菌(CR-AB)和耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布特征和耐药现状,合理指导临床使用抗菌药物。方法回顾性分析2011年1月至2014年3月该院住院患者CR-AB和MRSA的医院感染情况,利用纸片扩散法对收集的菌株进行药敏试验。结果共检出CR-AB 170株,主要分布在ICU病房,占61.17%(104/170);MRSA 168株,主要分布在神经外科,占27.98%(47/168)。痰液是CR-AB和MRSA最主要的标本来源,分别占67.06%和54.17%。CR-AB对多数抗菌药物的耐药率均达到50.00%以上,但对头孢派酮/舒巴坦(27.65%)、米诺环素(21.18%)、丁胺卡那霉素(19.41%)和妥布霉素(12.35%)耐药率低于30.00%,未发现耐多黏菌素的菌株;MRSA对利奈唑烷、万古霉素和替加环素100.00%敏感,对呋喃妥因和奎努普汀/达福普汀的耐药性也较低(<2.00%)。结论 CR-AB和MRSA的耐药性较为严重,应加强对重点感染病房的管理,合理选择抗菌药物,以防止CR-AB和MRSA等多重耐药菌株的传播。

Objective To provide a scientific reference for the choice of antimicrobial drugs by analyzing the distributions and the antimicrobial resistances of Carbapenem‐resistant Acinetobacter baumannii （CR‐AB） and methicillin‐resistant Staphylococcus au‐reus （MRSA） in the Northern Jiangsu People′s Hospital .Methods All the CR‐AB and the MRSA isolated from hospitalized pa‐tients from January 2011 to March 2014 were collected and analyzed .Use the disk diffusion method for antimicrobial resistance tes‐ting .Results A total of 170 CR‐AB strains and 168 MRSA strains were isolated .CR‐AB mainly distributed in the ICU ,which ac‐counting for 61 .17% （104/170） .MRSA mainly isolated in neurosurgery ,about 27 .98% （47/168） .67 .06% of CR‐AB strains and 54 .17% of MRSA strains were from Sputum specimens .The antimicrobial resistance rate of CR‐AB to most antimicrobial drugs were reached 50 .00% ,the resistance rates to cefoperazone/sulbactam （27 .65% ） ,minocycline （21 .18% ） ,amikacin （19 .41% ） and tobramycin （12 .35% ） were all less than 30 .00% ,the strain that resistant to polymyxin was not found .The sensitivity rates of MR‐SA to linezolid ,vancomycin ,and tigecycline were 100 .00% ,and the resistance rates to nitrofurantoin and kuinuputing/ dalfopristin were low （less than 2 .00% ） .Conclusion The antimicrobial resistances of CR‐AB and MRSA are serious .In order to control effec‐tively the spreading of CR‐AB ,MRSA and other multi‐drug resistant bacteria ,it′s necessary for us to strengthen the management of key departments ,and select antimicrobial drugs based on the results of drug susceptibility testing .