2016年清远地区金黄色葡萄球菌临床分离株耐药性监测

Antimicrobial resistance surveillance of Staphylococcus aureus in Qingyuan during 2016

目的了解2016年清远地区金黄色葡萄球菌临床分离株耐药特征。方法采用自动化仪器法进行细菌鉴定与药敏检测,采用Whonet5.6软件对细菌耐药率进行统计分析,采用CLSI 2016年版标准判断药敏结果。结果 2016年清远细菌耐药监测网3所医院共收集临床分离非重复金黄色葡萄球菌735株,其中脓液来源金黄色葡萄球菌占56.7%(417株),痰液来源占21.0%(154株),血液来源占11.2%(82株)。金黄色葡萄球菌对青霉素的耐药率为96.9%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为43.4%。脓液、痰液、血液来源金黄色葡萄球菌中MRSA检出率分别为46.5%、50.0%、20.7%;门诊、ICU、住院非ICU来源金黄色葡萄球菌中MRSA检出率分别为45.5%、41.5%、43.3%;新生儿、儿童、成人、老年人来源金黄色葡萄球菌中MRSA检出率分别为33.7%、60.2%、39.4%、47.9%。金黄色葡萄球菌对红霉素、克林霉素耐药率>40.0%,对庆大霉素、阿米卡星、环丙沙星、利福平、复方新诺明耐药率<15.0%,对高水平莫匹罗星耐药率为0.9%,对夫西地酸、万古霉素、利奈唑胺、奎奴普丁-达福普汀、替考拉宁、达托霉素耐药率为0.0%。结论清远地区金黄色葡萄球菌中MRSA检出率较高,加强金黄色葡萄球菌的耐药监测十分重要。

Objective To investigate the antimicrobial resistant characterization of Staphylococcus aureus in Qingyuan during 2016.Methods The identification of bacteria and antimicrobial susceptibility were performed by automated systems.The resistance rate was analyzed by WHONET5.6 software acording to CLSI2016 breakpoints.Results A total of 735 nonduplicate S.aureus isolates were collected from three hospitals during 2016,of which 56.7%（417 isolates）were isolated from pus specimens,21.0%（154 isolates）from sputum specimens,11.2%（82 isolates）from blood specimens.The resistance rate of S.aureus to penicillin was 96.9%.The overall prevalence of MRSA was 43.4%.The prevalence of MRSA from pus specimens,sputum specimens and blood specimens were 46.5%,50.0%,20.7%respectively.The prevalence of MRSA from outpatients,ICU and Non-ICU were 45.5%,41.5%,43.3%respectively.The prevalence of MRSA from neonates,children,adults and the elderly were 33.7%,60.2%,39.4%,47.9% respectively.More than 40.0% of S.aureus isolates were resistant to erythromycin and clindamycin.Less than 15.0% of S.aureus isolates were resistant to gentamicin,amikacin,ciprofloxacin,rifampin,and trimethoprim/sulfamethoxazole.The resistance rate to high-level mupirocin was 0.9%,and the resistance rates to fusidic acid, vancomycin, linezolid, quinupristin/dalfopristin, teicoplanin,daptomycin were 0.0%.Conclusion In Qingyuan area, the prevalence of MRSA was relatively high,therefore the surveillance of antimicrobial resistance in S.aureus is significant.