肿瘤患者耐甲氧西林金黄色葡萄球菌的临床分布与耐药性分析

Clinical distribution and drug-resistance of methicillin-resistant Staphylococcus aureus in tumor patients

目的调查肿瘤患者耐甲氧西林金黄色葡萄球菌(MRSA)医院感染的临床分布及耐药性,为制定医院感染的监测、预防和控制提供参考依据。方法采用回顾性调查方法,对我院2013年1-12月分离出的61株金黄色葡萄球菌中的34株M RSA菌株,从患者年龄、科室分布、标本来源及耐药性等方面进行分析。结果61株金黄色葡萄球菌中,M RSA检出率为55.74%;M RSA感染患者中,>50岁者占97.06%;检出标本以痰液、分泌物、胸腹水和血液为主,分别占44.12%、23.53%、17.65%、8.82%;感染科室主要包括肿瘤内科、头颈肿瘤外科、妇科,分别占35.29%、23.53%、14.71%;MRSA对万古霉素100.0%敏感,对青霉素、苯唑西林、氨苄西林和头孢唑啉的耐药率为100.0%,对红霉素、庆大霉素、克林霉素和四环素等抗菌药物的耐药率>80.0%。结论多重耐药菌的防控重点:加强肿瘤内科、头颈肿瘤外科的管理,采取合理、有效的防治措施,预防与控制MRSA医院感染的发生。

Objective To investigate the prevalence and antibiotic resistance of methicillin-resistance Staphylococcus aureus（ MRSA）,so as to provide the basis for the diagnosis,monitoring,prevention and control of hospital infection. Methods Thirty-four MRSA samples fromJanuary 2013 to December 2013 were analyzed according to the age of patients,department distribution,source of specimen and drug-resistance. Results MRSA detection rate was55. 74% in Staphylococcus aureus,and 97. 06% of the patients were over 50 years old. There were 44. 12%,23. 53%,17. 65% and 8. 82% of detected specimen came fromsputum,secretion,pleural effusion,ascites and blood. The detection cases mainly occurred in the department of medical oncology（ 35. 29%）,head and neck surgery（ 23. 53%） and gynecology（ 14. 71%）. The sensitivity of MRSA was 100% to vancomycin. The drug resistance rate of MRSA was100% to penicillin,oxacillin,ampicillin and cefazolin,and the rate was over 80% to ciprofloxacin,erythromycin,clindamycin and tetracycline. Conclusion It is important to strengthen management,take effective disinfection and isolation systemto prevent and control the MRSA infection in the oncology department and the head and neck surgery department.