耐甲氧西林金黄色葡萄球菌感染特点及耐药性分析

Clinical characteristics of methicillin-resistant staphylococcus aureus and analysis of drug resistance

目的对45株耐甲氧西林金黄色葡萄球菌（MRSA）感染的临床特点及耐药性进行分析，为，临床预防及治疗MRSA感染提供依据。方法收集2015年10月至2016年3月分离的耐甲氧西林金黄色葡萄球菌（MR—SA）45株，对患者的临床特点及药敏结果进行分析。结果共分离出MRSA45株，占金黄色葡萄球菌的48．91％。所有MRSA对青霉素、苯唑西林耐药，对庆大霉素、环丙沙星、左氧氟沙星、莫西沙星、红霉素、克林霉素、四环素、利福平、复方新诺明、替考拉宁耐药率分别为44．44％、48．89％、48．89％、48．89％、75．56％、75．56％、71．11％、44．44％、8．89％、2．22％，对奎奴普汀-达福普汀、利奈唑胺、万古霉素、替加环素、呋喃妥因均敏感。主要分布在ICU（22．22％）、呼吸内科（13．33％）、烧伤科（13．33％）。主要感染部位为：皮肤软组织（40％）、肺部（35．56％）。感染标本来源主要为脓液（35．56％）、痰（28．89％）、分泌物（20．00％）。结论MRSA感染分布广泛，呈现多重耐药性，临床可选用万古霉素、替考拉宁、替加环素、利奈唑胺治疗，同时应注意预防MRSA感染的流行。

Objective To analyze the clinical characteristics and drug resistance of methicillin- resistant staphylococcus aureus （MRSA） to guide for the reasonable clinical use of antibiotics. Methods A total of 45 strains of MRSA isolated from October 2015 to March 2016 were collected to analyze the clinical characteristics and resistance to antibiotics. Results A total of 45 MRSA strains were isolated, accounting for 48. 91% of staphylococcus aureus separated. Antimicrobial resistant rates to penicillin, oxacillin was 100%. All isolates were sensitive to quinupristin-dalfopristin, linezolid, vancomycin, tigecycline, furadantin. Resistant rates for other antimicrobial agents were as follows： gentamiein（44. 44% ）, ciprofloxacin（48. 89% ）, 1evofloxacin（48. 89% ）, moxifloxacin（48. 89% ）, erythromycin（75. 56% ）, clindamycin （75. 56% ）, tetracycline （71.11% ）, rifampicin （44. 44% ）, eotrimoxazole （ 8. 89% ）, teicoplanin （ 2. 22% ）. The strains were mainly distributed in ICU, respiratoy department, burn department. Major type of the sample where MRSA isolated were pus, suptum, secretion. Conclusions MRSA is worldwide in distribution and multiple resistant, clinical use vancomycin and teicoplanin, tigecycline and linezolid treating MRSA, meanwhile measures should be taking to stop the prevalence of MRSA.