不同标本类型分离的金黄色葡萄球菌药敏试验结果比较

Comparison of drug sensitivity test results of Staphylococcus aureus isolated from different types of specimen

目的了解不同标本类型分离的金黄色葡萄球菌的药敏性,并了解本院耐甲氧西林金黄色葡萄球菌(methicillin-resistant staphylococcus aureus,MRSA)的耐药情况。方法选取2013年7月—2015年6月接收的均检出金黄色葡萄球菌的皮肤分泌物、痰液、引流物、血液和尿液标本共405例,检测金黄色葡萄球菌对抗菌药物的敏感率,比较MSSA和MRSA的检出率及对抗菌药物的敏感率。结果不同标本检出的金黄色葡萄球菌对青霉素、万古霉素和替考拉宁的敏感率的差异均无统计学意义(P均>0.05);不同标本检出的金黄色葡萄球菌对阿莫西林/舒巴坦、头孢唑林、头孢呋辛等的敏感率差异均有统计学意义(P均<0.05)。405株金黄色葡萄球菌中共检出108株MRSA(26.67%);痰液的MRSA检出率最高(58.33%),皮肤分泌物的MRSA检出率最低(15.07%);不同标本的MRSA检出率的差异有统计学意义(P<0.05)。MSSA对抗菌药物的敏感率均显著高于MRSA,差异均有统计学意义(P均<0.05)。结论不同标本类型分离的金黄色葡萄球菌有不同的药敏性和MRSA检出率,临床治疗中应根据药敏试验结果合理选用抗菌药物。

Objective To learn the drug sensitivity of Staphylococcus aureus isolated from different specimens; To understand the drug resistance of MRSA in our hospital. Methods From July,2013 to June,2015,405 cases of skin secretions,sputum drainage,blood and urine samples were received. Staphylococcus aureus were detected in all of the specimens. The sensitivity of Staphylococcus aureus to antimicrobial agents was detected,the detection rate of MRSA was compared,and the sensitivity of MSSA and MRSA to the antimicrobial susceptibility was compared. Results The differences on the sensitive rates of Staphylococcus aureus isolated from different specimens to penicillin,vancomycin and teicoplanin were not statistically significant（ P〈0. 05）; The differences on the sensitive rates of Staphylococcus aureus isolated from different specimens to amoxicillin / sulbactam,cefazolincefuroxime,erythromycin,azithromycin,clindamycin,gentamicin,levofloxacin were statistically significant（ P〈0. 01）. One hundred and eight strains of MRSA were detected in 405 strains of Staphylococcus aureus,MRSA positive rate was 26. 67%; MRSA detection rate of sputum was highest,58. 33%; the lowest MRSA detection rate was 15. 07%,from skin secretions; there were statistically significant differences in MRSA detection rates of different samples（ χ-2= 59. 957,P〈0. 05）. The sensitivity rates of MSSA to penicillin,amoxicillin / sulbactam,cefazolin,cefuroxime,erythromycin,azithromycin,clindamycin,gentamicin,levofloxacin,vancomycin and teicoplanin were significantly higher than that of MRSA,the differences were statistically significant（ P〈0. 01）. Conclusion Staphylococcus aureus isolated from different types of samples have different drug sensitivity and MRSA detection rate. The clinical treatment should be based on the results of drug sensitivity test to select rational antibacterial drugs.