891株金黄色葡萄球菌的临床分布特点及耐药性分析

Clinical distribution and drug-resistance analysis of 891 clinical isolates of Staphylococcus aureus

目的分析某院2014~2018年临床分离的金黄色葡萄球菌的临床分布特点和其耐药性,为临床合理使用抗菌药物提供依据。方法常规分离菌株,采用MIC测定法进行抗菌药物敏感试验,根据CLSI 2016标准采用WHONET 5.6软件和SPSS 19.0软件进行统计分析。结果临床分离的891株金黄色葡萄球菌,其中耐甲氧西林金黄色葡萄球菌(MRSA)菌株185株(20.76%),主要来源于脓液(22.25%)、痰液(21.66%)、血液(16.16%)、分泌物(13.35%)及伤口(12.46%);以外科病房尤其是骨科病房检出率(20.99%)最高。金黄色葡萄球菌对万古霉素、利奈唑胺、呋喃妥因、达托霉素高度敏感,敏感率依次为98.76%、97.75%、97.08%、95.96%,对青霉素G耐药率最高(95.96%),其次为氨苄西林(89.00%)和红霉素(61.84%),对其它β-内酰胺类、大环内酯类、喹诺酮类药物等敏感性较好(大于55%)。结论金黄色葡萄球菌对不同抗菌药物耐药性有较大差异,但对万古霉素、利奈唑胺依然保持很高的敏感性。

Objective To investigate the distribution profile and drug-resistance to the common antibiotics of clinical Staphylococcus aureus from 2014 to 2018, and to provide guidance for rational use of antimicrobial agents. Methods A total of 11 strains tested were isolated from clinical specimens and their antimicrobial susceptibility was assessed via MIC method, followed by the analysis of the results with WHONET 5.6 and SPSS 19.0 software based on the CLSI 2016 guideline. Results A total of 891 strains of Staphylococcus aureus were isolated from various clinical specimens, including 185 strains of MRSA. Most of these Staphylococcus aureus were from pus(22.25%), sputum(21.66%), blood(16.16%), secreta(13.35%), and wound(12.46%). The strains were isolated mainly from neurosurgical department, especially orthopedics(20.99%). Staphylococcus aureus is highly sensitive to vancomycin, linezolid, nitrofurantoin, daptomycin, and the sensitivity rates are 98.76%, 97.75%, 97.08%, and 95.96%, respectively. Staphylococcus aureus has the highest resistance rate to penicillin G(95.96%), followed by ampicillin(89.00%) and erythromycin(61.84%), and it is more sensitive(more than 55%) to other β-lactams, macrolides, and quinolones. Conclusion Staphylococcus aureus has great differences in resistance to different antimicrobial agents. However, vancomycin and linezolid are still highly active against Staphylococcus aureus.