医院耐甲氧西林金黄色葡萄球菌的临床分布特征及耐药性分析

Clinical Distribution and Drug Resistance of Methicillin-resistant Staphylococcus Aureus in Hospitals

目的探讨医院中耐甲氧西林金黄色葡萄球菌(MRSA)的分布特点和耐药性情况。方法选择该院2016年7月—2017年11月分离的76株MRSA标本,对其分布情况进行分析,并展开药敏实验,分析其耐药性。结果 76株MRSA中,痰液检出率最高,为39.47%,其次为分泌物,为25.00%;最后是脓液,检出率为18.42%,与其他几种样本类型对比差异有统计学意义(P<0.05)。从科室方面来看,ICU分布率最高,为32.89%,其次为呼吸内科,为26.32%,最后是烧伤科,为19.74%,与其他科室所占比例相比差异有统计学意义(P<0.05)。MRSA对青霉素、阿奇霉素、环丙沙星、红霉素、四环素、庆大霉素、克林霉素、万古霉素、呋喃妥因以及氯霉素的耐药率依次为100.00%、96.05%、97.36%、94.74%、73.68%、85.53%、60.53%、0.00%、7.89%、10.53%,万古霉素耐药率最低,其次是呋喃妥因,最后是氯霉素,与其他药物比较差异有统计学意义(P<0.05)。结论 MRSA多分布于骨科科、伤口分泌物标本,对多种抗菌药物均有耐药性,治疗时需依据药敏实验结果灵活选用抗生素。

Objective To investigate the distribution and drug resistance of methicillin-resistant Staphylococcus aureus（MRSA） in hospitals. Methods 76 MRSA specimens isolated from the hospital from July 2016 to November 2017 were analysed for their distribution and drug susceptibility testing was conducted to analyze their drug resistance. Results Among the76 strains of MRSA, the highest detection rate of sputum was 39.47%, followed by secretion, which was 25.00%; the last was pus, the detection rate was 18.42%, which was compared with other types of samples, with difference statistical significance（P〈0.05）.From the perspective of the department, the highest ICU distribution rate was 32.89%, followed by respiratory medicine, 26.32%, and finally burns, which was 19.74%, which was statistically significant compared with other departments（P〈0.05）. MRSA resistance rates to penicillin, azithromycin, ciprofloxacin, erythromycin, tetracycline gentamicin,clindamycin, vancomycin, nitrofurantoin, and chloramphenicol were 100.00%, 96.05%, 97.36%, 94.74%, 73.68%, 85.53%,60.53%, 0.00%, 7.89%, 10.53%. The vancomycin resistance rate was the lowest, followed by nitrofurantoin, and finally chloramphenicol, which was statistically significant compared with other drugs（P〈0.05）. Conclusion MRSA is mostly distributed in specimens of orthopaedics and wound secretions, and it is resistant to various antibiotics. Therefore, antibiotics should be used flexibly according to the results of drug sensitivity test.