120株耐甲氧西林金黄色葡萄球菌的临床分布及耐药性分析

Clinical distribution and drug resistance analysis of 120 strains of methicillin resistant Staphylococcus aureus

目的分析耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及耐药性,为临床合理用药及医院感染防控提供依据。方法回顾性分析本院2012年7月-2015年6月分离的MRSA株,用WHONET 5.6软件分别按照标本来源、科室分布及药物敏感性进行统计分析,用SPSS 17.0软件进行组间比较。结果本院3年间共分离出金黄色葡萄球菌366株,其中MRSA 120株,MRSA的分离率为32.8%。MRSA的标本来源以痰液、脓液、血液为主,分别占51.7%、30.8%、13.3%。临床科室分布以ICU、创伤外科、儿科为主,分别占25.0%、20.8%、14.2%。MRSA对多种抗菌药物均呈现不同程度的耐药性,对万古霉素、替加环素、利奈唑胺完全敏感。MRSA对苯唑西林、克林霉素、庆大霉素、四环素、左旋氧氟沙星、利福平、环丙沙星、莫西沙星、奎奴普丁/达福普汀、呋喃妥因的耐药率均高于MSSA,差异有统计学意义(P<0.05)。结论 MRSA的耐药形势十分严峻,应定期监测MRSA的临床分布及耐药性,并采取有效措施预防和控制医院感染的发生。

Objective To analyze the clinical distribution and drug resistance of methicillin resistant Staphylococcus aureus（ MRSA）,so as to provide basis for the clinical rational use of drugs and for the prevention of hospital infection.Methods MRSA strains isolated from July 2012 to June 2015 in our hospital were analyzed statistically by WHONET 5. 6 software. Analysis was performed by specimens source,clinical distribution and drug sensitivity. The difference between the two groups was statistically analyzed by SPSS 17. 0 software. Results 366 strains of Staphylococcus aureus were isolated from 3years in our hospital,among which 120 were MRSA strains. The isolation rate of MRSA was 32. 8%. MRSA isolated from sputum,pus and blood,accounted for 51. 7%,30. 8% and 13. 3%,respectively. Clinical distribution in ICU,trauma surgery,pediatrics accounted for 25. 0%,20. 8%,14. 2%,respectively. MRSA was resistant to various antimicrobial drugs. It is totally sensitive to vancomycin,tigecycline and linezolid. The resistance rates of MRSA to oxacillin,clindamycin,gentamicin,tetracycline,levofloxacin,rifampicin,ciprofloxacin,moxifloxacin,quinupristin / dalfopristin,nitrofurantoin were higher than those of the MSSA,and the difference had statistical significance（ P〈0. 05）. Conclusion The drug resistance of MRSA is very severe,so clinical distribution and drug resistance of MRSA should be regularly monitored. We also should take effective measures to prevent and control the occurrence of hospital infection.