ICU患者下呼吸道感染耐甲氧西林金黄色葡萄球菌耐药性分析

A drug resistance analysis for MRSA infecting lower respiratory tract of patient in ICU

目的:分析医院重症监护室(ICU)下呼吸道感染患者痰标本中耐甲氧西林金黄色葡萄球菌(MRSA)的分离率及耐药情况,以指导临床合理使用抗生素。方法:收集医院ICU506例下呼吸道感染患者痰标本,以进行细菌培养鉴定及药物敏感试验,对鉴定及药敏结果进行分析并探讨其耐药特点。结果:在506例患者痰标本中共分离出金黄色葡萄球菌79株,其中MRSA71株,所分离MRSA对万古霉素、替考拉宁和利奈唑胺的敏感率均为100%,对苯唑西林、青霉素为全耐药;MRSA与甲氧西林敏感金色葡萄球菌(MSSA)对利福平的耐药率比较,其差异有统计学意义(x^2=30.15,P<0.05)。结论:为有效减少及预防耐甲氧西林金黄色葡萄球菌的感染及流行,应根据患者药敏结果及耐药特点制定个体化、合理化的治疗方案。

Objective:To investigate the isolation rate and drug resistance of methicillin resistant staphylococcus aureus(MRSA)from sputum sample of patients with infection in lower respiratory tract of intensive care unit(ICU)so as to guide the reasonable using of antibiotic in clinical practice.Methods:Sputum samples of506patients with lower respiratory tract infection of ICU were collected and then they were implemented bacteria culture,identification and drug sensitivity experiment.The results of identification and drug sensitivity were analyzed and the characteristics of drug resistance were analyzed and discussed.Results:There were79strains staphylococcus aureus included71strains MRSA were isolated from the sputum samples of506patients.The sensitivity rates of isolated MRSA were100%for vancomycin,teicoplanin and linezolid.At the same time,it was whole drug resistance for oxacillin and penicillin.The difference for rifampicin between MRSA and methicillin susceptible staphylococcus aureus(MSSA)was significant(x2=30.15,P<0.05).Conclusion:The therapeutic schedule of individualization and rationalization should be formulated according to the result of drug sensitivity and the characteristics of drug resistance of patient so as to efficiently reduce and prevent the infection and prevalence of MRSA.