某院耐甲氧西林金黄色葡萄球菌临床分离株的分布与抗生素敏感性分析

Distribution and antibiotic sensitivity analysis of clinical isolates of methicillin resistant Staphylococcus aureus in a hospital

目的分析某院耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布和耐药性特点。方法收集该院2014年-2017年微生物室分离的MRSA,运用WHONET 5.6软件分析其临床分布、标本类型和药敏情况。结果共收集到MRSA 311株,标本类型主要为痰液179株,占57.6%;分泌物87株,占28.0%;血液17株,占5.5%。临床科室分布主要为神经外科92例,占29.6%;儿科49例,占15.8%;ICU 47例,占15.1%;骨科28例,占9.0%。药敏试验显示,MRSA对万古霉素、利奈唑胺、替加环素、奎奴普丁/达福普汀有很高的敏感率,达99%以上,对其余多种抗菌药均产生程度不同的耐药性。结论 MRSA耐药性强,抗生素滥用、免疫力低下患者、创伤性治疗是其感染的危险因素,因此应加强监测,合理使用抗生素,减少和控制MRSA菌株的产生和传播。

Objective To analyze the infection and drug resistance of methicillin resistant Staphylococcus aureus(MRSA)in a hospital.Methods MRSA were collected from 2014 to 2017,and the clinical distribution,specimen type and drug susceptibility were analyzed.Results Among the 311 MRSA strains,179 strains came from phlegm,accounting for 57.6%,87 strains from secretions,accounting for 28.0%,17 strains from blood,accounting for 5.5%.According to the distribution in clinical departments,92 cases came from neurosurgery,accounting for 29.6%,49 cases from pediatric,accounting for 15.8%,47 cases from ICU,accounting for 15.1%,28 cases from orthopedic,accounting for 9.0%.Antimicrobial susceptibility test showed that MRSA had high sensitivity to vancomycin,linazolamide,tigarin,quinuprine/duphutin(>99%),and had different resistances to other antimicrobials.Conclusion Strong MRSA resistance,abuse of antibiotics,immune compromise,traumatic treatment are the risk factors for infection,so the clinical laboratory and clinical departments should strengthen the monitoring,rational use of antibiotics,reduce and control the production and propagation of MRSA strains.