2011—2014年鄂州市金黄色葡萄球菌耐药性分析

Resistance Surveillance of Staphylococcus Aureus in Ezhou City from 2011 to 2014

目的分析金黄色葡萄球菌(staphylococcus aureus,SAU)的耐药情况,为临床合理使用抗菌药物提供科学依据。方法收集湖北省鄂州市某院2011年1月—2014年12月期间分离的SAU菌株,采用K-B纸片扩散法进行药敏试验,以CLSI 2010年推荐标准判读药敏结果。数据的整理和分析采用Excel 2010和SPSS 20.0软件进行。结果共检出耐甲氧西林金黄色葡萄球菌(MRSA)277株(44.04%),主要分离来自重症监护病房(31.05%)、呼吸内科(20.58%)和神经外科(18.41%)。MRSA检出率在痰标本中最高(56.13%)。MRSA菌株除对替加环素、替考拉宁、利奈唑胺和万古霉素敏感外,对其他15种临床常用抗菌药物均表现出不同程度的耐药。MRSA对各种抗菌药物的耐药率要明显高于甲氧西林敏感金黄色葡萄球菌(MSSA),且差异均具有统计学意义。结论鄂州地区SAU对多种抗菌药物耐药,临床上应根据药敏试验对SAU感染患者合理使用抗菌药物,以减少耐药菌株的产生,并需加强对MRSA菌株耐药性的监测。

Objectives To provide scientific basis for clinical rational use of antimicrobial agents by analyzing the drug-resistance of Staphylococcus aureus（SAU）.Methods SAU isolated from a hospital in Ezhou city of Hubei province from January 2011 to December 2014 were collected.The antimicrobial susceptibility was determined by the Kirby-Bauer disk diffusion method.Results was evaluated according to the CLSI（Clinical and Laboratory Standards Institute）2010.Excel 2010 and SPSS 20.0 were used for the data collection and analysis.Results A total of 277（44.04%）strains of Methicillin-resistant Staphylococcuaureus（MRSA）were isolated.The infected MRSA inpatients were mainly in intensive care unit（31.05%）,respiratory department（20.58%）and neurosurgery department（18.41%）.56.13% of SAU from sputum specimens were MRSA.All the strains of MRSA were sensitive to tigecycline,teicoplanin,linezolid and vancomycin,but resistant to the other 15 kinds of antimicrobial agents in different degrees.The drug-resistance rate of MRSA was higher than the rate of Methicillin-sensitive Staphylococcus aureus（MSSA）for each antimicrobial agent,and all the differences were statistically significant.Conclusions SAU is resistant to many kinds of antimicrobial agents in Ezhou City.Clinical application of antimicrobial agents on patients infected by SAU should be determined according to the results of antimicrobial susceptibility,so as to reduce drug resistance.And the surveillance on drug resistance of MRSA should be strengthened.