病毒性肝炎住院患者葡萄球菌属感染与耐药性研究

Staphylococcusinfection and drug resistance in hospitalized patients with viral hepatitis

目的探讨病毒性肝炎住院患者葡萄球菌属感染与耐药性,为合理使用抗菌药物提供依据。方法选取2013年11月-2014年12月住院治疗的病毒性肝炎合并葡萄球菌属感染患者80例,留取患者感染标本送检,采用法国生物梅里埃公司VITEK-AMS6全自动细菌鉴定系统进行葡萄球菌属鉴定,并使用纸片扩散法(K-B)进行药敏试验,分析葡萄球菌属的耐药性。结果 80例病毒性肝炎合并葡萄球菌属感染患者送检标本检出108株葡萄球菌属,金黄色葡萄球菌28株占25.93%,凝固酶阴性葡萄球菌80株占74.07%,金黄色葡萄球菌及凝固酶阴性葡萄球菌在标本中检出均以痰液为主,分别占64.29%及43.75%,其次均为血液、尿液、腹水,分别占17.86%及25.00%、10.71%及18.52%、7.14%及9.26%;耐甲氧西林金黄色葡萄球菌检出率为28.57%,耐甲氧西林凝固酶阴性葡萄球菌检出率为11.25%,耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌耐药性均较严重,对青霉素、苯唑西林耐药率均达100.00%,仅对万古霉素耐药率为0。结论病毒性肝炎住院患者葡萄球菌属的组成、来源、耐药性各有其特点,需要动态监测并根据结果正确选择抗菌药物治疗,以减少感染的发生率。

OBJECTIVE To study Staphylococcus infection and drug resistance in hospitalized patients with viral hepatitis,so as to provide the basis for rational use of antimicrobial drugs.METHODS Totally 80 cases of viral hepatitis patients in our hospital in Nov.2013-Dec.2014 were selected.Samples were collected for tests.The VITEK-AMS6full-automatic system（Bio-merieux,France）was used for identification of Staphylococcus strains and the K-B method was used for drug sensitivity test to analyze the drug resistance of Staphylococcus strains.RESULTS In the 108 strains of Staphylococci,there were 28strains（25.93%）of Staphylococcus aureus and 80strains（74.07%）of coagulase negative Staphylococci.S.aureus and Staphylococci were mainly found in sputum accounting for 64.29% and 43.75%respectively,followed by blood（17.86% and 25.00%）,urine（10.71% and18.52%）and ascites（7.14% and 9.26%）.The detection rates of methicillin-resistant S.aureus and coagulase negative Staphylococci were 28.57%and 11.25%.The resistance of methicillin-resistant S.aureus and coagulase negative Staphylococci was serious as their resistance was 100.00%to penicillin and oxacillin,however,their resistance was 0to vancomycin.CONCLUSION As constitution,sources and resistance of Staphylococci in viral hepatitis inpatients have their own characteristics,it is needed to monitor and correctly choose antibiotic treatment based on the test results to reduce the incidence of infections.