金黄色葡萄球菌临床分布与耐药性分析

Clinical distribution and drug resistance of Staphylococcus aureus

目的了解医院金黄色葡萄球菌(SAU)的临床分布及耐药性,为临床合理用药提供指导。方法回顾性分析2013年1-12月临床标本分离的126株SAU的分布及耐药性,分离的菌株采用MicroScan WalkAway 96PLUS全自动细菌分析仪及配套的PC33检测卡进行鉴定和药敏试验,使用WHONET5.6软件进行统计分析。结果 126株SAU主要来自于痰液和分泌物,分别占34.1%和50.8%;科室分布以ICU、骨科和儿科为主,分别占14.3%、20.6%和11.9%;126株SAU中有42株耐甲氧西林金黄色葡萄球菌(MRSA),占33.3%;SAU对13种抗菌药物耐药率排在前4位的是氨苄西林占97.6%、青霉素占95.2%、红霉素占75.4%及环丙沙星占44.4%;对利奈唑胺和万古霉素的敏感率均为100.0%。结论医院分离的SAU耐药严重,尤其是MRSA多药耐药严重,微生物室应加强对MRSA耐药性的监测。

OBJECTIVE To understand the clinical distribution and drug resistance of the Staphylococcus aureus so as to provide guidance for reasonable clinical use of antibiotics.METHODS The distribution and drug resistance of126 strains of S.aureus that were isolated from clinical specimens from Jan 2013 to Dec 2013 were retrospectively analyzed,then the isolated strains were identified by using MicroScan WalkAway 96 PLUS automatic bacteria analyzer PC33 test card,the drug susceptibility testing was carried out,and the statistical analysis was performed with the use of WHONET5.6software.RESULTS Of 126 strains of S.aureus,34.1% were isolated from the sputum specimens,and 50.8% were isolated from the secretions;14.3% were isolated from the ICU,20.6% were isolated from the department of orthopedics,and 11.9% were isolated from the department of pediatrics.There were 42（33.3%）strains of methicillin-resistant S.aureus（MRSA）among the 126 strains of S.aureus.Among the 13 antibiotics,the drug resistance rates of the S.aureus to ampicillin,penicillin,erythromycin,and ciprofloxacin were 97.6%,95.2%,75.4%,and 44.4%,respectively,ranking the top 4places;the drug susceptibility rates to linezolid and vancomycin were 100.0%.CONCLUSION The clinical S.aureus isolates are highly drug-resistant,and the MRSA strains are highly multidrug-resistant;it is necessary for the microbiology laboratory to strengthen the surveillance of drug resistance of the MRSA strains.