血培养检出金黄色葡萄球菌分布及药敏分析

Distribution and antibiotic sensitivity of Staphylococcus aureus strains isolated from blood culture

目的回顾分析北京友谊医院血培养阳性金黄色葡萄球菌的耐药及分布情况,为抗菌药物在临床中的合理使用提供依据。方法查阅2013年1月至2015年12月该院87株非重复血培养金黄色葡萄球菌患者的病历资料,菌种鉴定使用VITEK全自动微生物鉴定仪,药物敏感检测采用K-B法。结果 2013年1月至2015年12月从临床送检的血培养标本分离出非重复金黄色葡萄球菌87株,耐甲氧西林金黄色葡萄球菌(MRSA)29株,近3年逐年增多,平均检出率为33.3%;3年间金黄色葡萄球菌对万古霉素、利奈唑胺、呋喃妥因、替加环素完全敏感;对喹奴普定/达福普汀、复方磺胺甲噁唑、利福平敏感性尚好,敏感率均在80.0%以上;对苯唑西林敏感率呈逐年下降趋势,3年间比较差异有统计学意义(P<0.05);对常用抗菌药物的敏感率,甲氧西林敏感金黄色葡萄球菌(MSSA)均高于MRSA,其中对环丙沙星、红霉素、庆大霉素、左氧氟沙星、莫西沙星、四环素的敏感率经比较差异有统计学意义(P<0.05)。结论血培养中金黄色葡萄球菌对药物敏感性较差,MRSA多药耐药性高,应加强监测,合理应用抗菌药物。

Objective To analyze distribution and antibiotic sensitivity of Staphylococcus aureus strains isolated from blood culture,in order to provide a theory reference for clinical antibiotics use.Methods The clinical data of 87 patients with non-repetitive blood culture of Staphylococcus aureus were collected from January 2013 to December 2015.The isolated bacteria were identified by the VITEK system,their antibiotic sensitivities were tested by Kirby-Bauer method.SPSS22.0software was used in statistical analysis.Results Of the 87 Staphylococcus Aureus strains isolated from January 2013 to December 2015,29 were methicillin-resistant staphylococcus.Aureus（MRSA）which was increasing in the past 3years,accounting for 33.3%.No resistance of Staphylococcus aureus to VAN,LNZ,NIT and TGC was found;the sensitive rate of Staphylococcus aureus was above 80.0% to QDA,SXT and RIF;the oxacillin susceptible rate showed a declining trend,with statistical significance difference in 3years（P〈0.05）.The sensitive rate of antibacterial drugs,methicillin sensitive Staphylococcus aureus（MSSA）was higher than that of MRSA,the sensitivity rate to CIP,ERY,GEN,LVX,MFX and TCY with significant differences（P〈0.05）.Conclusion Staphylococcus aureus in blood culture is less sensitive to drugs,MRSA multi-drug resistance is high,which should be strengthen the monitoring,rational use of antimicrobial drugs.