住院精神病患者呼吸道感染耐甲氧西林金黄色葡萄球菌耐药性分析

Resistance analysis of methicillin-resistant Staphylococcus aureus in psychosis inpatients with respiratory tract infection

目的分析住院精神病患者呼吸道感染流行所分离的113株耐甲氧西林金黄色葡萄球菌(MRSA)的耐药特征,为临床合理使用抗菌药物提供参考。方法对呼吸道分泌物标本采用梅里埃VITEK2 Compact全自动微生物分析仪对菌株鉴定到金黄色葡萄球菌;MRSA表型检测采用美国临床实验室标准化委员会(CLSI)推荐的头孢西丁纸片扩散法;MRSA菌株mec A基因检测采用PCR法;药敏试验采用CLSI推荐的K-B纸片扩散法。结果从呼吸道分泌物标本中共分离到117株金黄色葡萄球菌,经MRSA表型检测均阳性,再经mec A基因检测113株为MRSA;药敏试验结果显示,MRSA对万古霉素、利奈唑胺、替考拉宁100%敏感,耐药率超过50%的有14种,其中对青霉素G、苯唑西林、头孢唑啉、氨苄西林100%耐药。结论本院住院精神病患者呼吸道感染分泌物标本分离的MRSA耐药谱广,耐药率高,并且MRSA表现为多重耐药。提示临床应合理使用抗菌药物,加强MRSA监测与防控工作,避免MRSA菌株进一步扩散传播。

Objective To analyze the drug resistance characteristics of 113 strains of methicillin resistant Staphylococcus aureus(MRSA)isolated from the epidemic of respiratory tract infection in inpatients with psychosis,and to provide reference for the rational use of antibiotics in clinic.Methods Staphylococcus aureus was identified by VITEK2 Compact automatic microbial analyzer.The phenotypic detection of MRSA was detected by cefoxitin disk diffusion method recommended by(CLSI),and the mecA gene of MRSA strain was detected by polymerase chain reaction(PCR);drug sensitivity test was performed by the disk diffusion method recommended by CLSI.Results A total of 117 strains of Staphylococcus aureus were isolated from respiratory tract secretions,and all of them were positive by MRSA phenotypic test,and then 113 strains positive were detected by mecA gene;drug sensitivity test showed that MRSA was 100%sensitive to vancomycin,linazolamine and teicoplanin,there are 14 kinds of resistance rates exceeding 50%.Among them,there were 100%resistance to penicilling,oxacillin,cefazolin and ampicillin.Conclusion The MRSA isolated from the infected secretions of psychotic patients in our hospital has a wide drug resistance spectrum and a high drug resistance rate,and MRSA shows multiple drug resistance.It is suggested that antibiotics should be used reasonably in clinic,monitoring and control of MRSA should be strengthened,and further spread of MRSA strain should be avoided.