2008年-2016年金黄色葡萄球菌临床分离率与耐药性变迁的研究

Clinical isolation of Staphylococcus aureus and its drug resistances from 2008 to 2016

目的了解浙江省人民医院2008年-2016年金黄色葡萄球菌的临床分布特征、对抗菌药物的耐药特点及耐甲氧西林金黄色葡萄球菌(MRSA)检出动态,为临床合理使用抗菌药物提供理论依据。方法采用VITEK 2 Compact全自动细菌检测分析系统和微量稀释法对临床分离的金黄色葡萄球菌进行细菌鉴定及药敏试验,采用WHONET 5.6和SPSS 17.0软件对金黄色葡萄球菌的标本来源、科室分布及耐药性等进行统计分析。结果共分离到金黄色葡萄球菌5 060株;各类标本中痰液标本检出率最高,占53.99%,分泌物标本次之,占12.57%;金黄色葡萄球菌中检出率最高的科室是ICU,占12.21%,其次是儿科,占9.94%;共检出2 677株MRSA,其检出率为52.9%;9年分离的金黄色葡萄球菌对青霉素G、红霉素、左旋氧氟沙星、苯唑西林、环丙沙星、莫西沙星均具有较高的耐药性。结论该院检出的金黄色葡萄球菌对多种抗菌药物可产生不同程度的耐药性,故应加强临床合理使用抗菌药和感染控制的监管。

Objective To investigate the clinical distribution of Staphylococcus aureus and its drug resistance to antimicrobial drugs,as well as detection rate of methicillin-resistant Staphylococcus aureus（ MRSA） from 2008 to 2016 in the Zhejiang Provincial People＇s Hospital,so as to provide reference for the rational clinical use of antibiotics. Methods The bacterial identification and drug susceptibility test of clinical isolates of Staphylococcus aureus were carried out by using VITEK 2 Compact automatic bacterial detection and analysis system and microdilution method. The origin,distribution and drug resistance of Staphylococcus aureus were analyzed by WHONET 5. 6 and SPSS 17. 0 software for statistical analysis. Results A total of 5 060 Staphylococcus aureus isolates were isolated. The detection rate of sputum specimens was the highest in all kinds of specimens,accounting for 53. 99%,followed by secretion specimens,accounting for 12. 57%. The highest detection rate of Staphylococcus aureus was in ICU room,accounting for 12. 21%,followed by pediatrics,accounting for 9. 94%; a total of 2 677 strains of MRSA were detected,and the detection rate was 52. 9%; nine years of Staphylococcus aureus isolates were highly resistant to penicillin G,erythromycin,levofloxacin,Oxacillin,ciprofloxacin,moxifloxacin. Conclusion S. aureus detected in this hospital may have different levels of resistance to various antimicrobial drugs,and supervision should be strengthened with clinically rational use of antimicrobial drugs and infection control.