2010-2016年临床分离金黄色葡萄球菌的耐药性分析

Analysis on drug resistance of Staphylococcus aureus between 2010 and 2016

目的对北京天坛医院2010-2016年分离的金黄色葡萄球菌的临床分布及耐药情况进行统计分析。方法利用WHONET5.6及SPSS20.0软件,分析2 230株金黄色葡萄球菌分离株在不同科室、不同标本的临床分布特征,分析金黄色葡萄球菌种常用抗菌药物的耐药情况。结果金黄色葡萄球主要分离自痰液(78.75%)、血液(4.01%)、分泌物(10.13%)及脑脊液(4.53%)中,主要来源科室包括神经外科病区(19.14%)、脑血管病中心(22.54%)及综合ICU(18.58%)等。结果显示2010-2016年金黄色葡萄球菌对多数常用抗菌药物的耐药率均出现明显下降,对万古霉素、利奈唑胺、替考拉宁的耐药率均低于5%,耐甲氧西林金黄色葡萄球菌的检出率也呈逐年下降趋势。来源于不同科室或标本的金黄色葡萄球菌的耐药率比较,差异均有统计学意义(P<0.05)。结论金黄色葡萄球菌对临床常用抗菌药物的耐药情况严重。对万古霉素、利奈唑胺、替考拉宁的耐药率较低,可作为临床用药首选。

Objective To analysis distribution and drug resistance of Staphylococcus aureus isolated from Beijing tiantan hospital between 2010 and 2016.Methods A total of 2 230 isolated strains were collected between 2010 and 2016.The distribution and drug resistance of these strains were analyzed in different departments,specimen types and years by using WHONET5.6 and SPSS20.0.Results The Staphylococcus aureus strains were mainly isolated from sputum（78.75%）,blood（4.01%）,cervical（10.13%）and cerebrospinal fluid（4.52%）,and the main source of departments including the department of neurosurgery ward（19.14%）,the center of cerebrovascular disease（22.54）and the general ICU（18.58%）.The resistance of isolates to the most commonly antibiotics were decreased from 2010 to 2016,and the resistance to vancomycin,linezolid and teicoplanin were all lower than5%.The detection rate of MRSA also decreased year by year.And there were significant differences in the resistance rates of Staphylococcus aureus from different departments or specimens（P〈0.05）.Conclusion The resistance of Staphylococcus aureus to the clinical antibiotics is serious.The resistance rates of the isolates to vancomycin,linezolid and teicoplanin are low,and the three antibiotics could be used as the preferred clinical medication.