医院临床分离金黄色葡萄球菌医院感染分布及其耐药性调查

Investigation on hospital-acquired infection distribution and drug resistance of clinical-isolated Staphylococcus aureus

目的了解医院临床分离金黄色葡萄球菌医院感染分布及其耐药性变迁情况。方法采用回顾性调查方式,对某医院连续3年住院患者送检标本分离的金黄色葡萄球菌感染患者的感染来源及病原菌耐药性进行调查与分析。结果3年内共分离出的金黄色葡萄球菌1 553株,其中耐甲氧西林(MRSA)菌株占42. 95%。金黄色葡萄球菌主要分离自痰液、分泌物和脓液,构成比分别为46.88%、14.49%和13.65%;其中85.58%的菌株分离自社区感染患者,医院内获得感染仅占14.42%。临床分离的金黄色葡萄球菌对青霉素耐药率达到95. 2%,对克林霉素、四环素及复方新诺明耐药逐年降低;MRSA医院感染菌株对四环素、莫西沙星、喹努普汀/达福普汀和利福平耐药率高于社区感染。结论该医院金黄色葡萄球菌分离率较高,主要来自社区感染,耐药菌株比例较高,临床应根据药敏结果合理选用抗菌药物。

Objective To investigate the distribution of hospital-acquired infection and drug resistance of clinical-isolated Staphylococcus aureus. Methods A retrospective survey was conducted to investigate the infection source and pathogen resistance of patients with Staphylococcus aureus infection in a hospital for 3 consecutive years. Results A total of 1 553 strains of Staphylococcus aureus were isolated within 3 years,of which methicillin-resistant Staphylococcus aureus( MRSA)strains accounted for 42. 95%. The clinical specimens of Staphylococcus aureus were mainly isolated from sputum specimens,followed by secretions and pus specimens,with composition ratios of 46. 88%,14. 49%,and 13. 65%,respectively.Of the clinically isolated Staphylococcus aureus,85. 58% of the strains were isolated from community-infected patients,and only 14. 42% were infected in hospitals. The resistance rate of clinically isolated Staphylococcus aureus to penicillin reached95. 2%,and the resistance to clindamycin,tetracycline and sulfamethoxazole decreased year by year. Hospital-acquired MRSA strains had higher resistance rate to tetracycline,moxifloxacin,quinoptine/tamperin and rifampicin than that of community-acquired strains. Conclusion The isolation rate of Staphylococcus aureus in this hospital is very high,mainly from community infection,and the proportion of drug-resistant strains is also high. Antibiotics should be rationally selected according to the results of drug susceptibility.