2019年1—12月某院金黄色葡萄球菌的临床分布与耐药性分析

An analysis of the clinical distribution and drug resistance of the staphylococcus aurei in a hospital from January to December 2019

目的分析我院2019年检出的所有金黄色葡萄球菌(SA)的临床分布及耐药性特点,为临床合理使用抗生素及有效的院感控制提供依据。方法回顾性分析我院2019年检出的SA的科室分布、标本来源和耐药性等特征。结果2019年共检出SA 748株,其中耐甲氧西林金黄色葡萄球菌(MRSA)173株;这些菌株大部分分布在儿科(28.21%),烧伤整形外科(25.53%),皮肤科(5.35%),创伤骨科(4.95%);标本来源:伤口分泌物383株,咽拭子138株,痰液78株,血液47株,脓液45株,尿液24株,脐分泌物18株,其他标本15株;药敏结果显示,SA对青霉素的耐药率为87.97%,阿奇霉素、克拉霉素、红霉素、克林霉素、四环素、苯唑西林、头孢西丁的耐药率分别为47.06%、46.12%、46.12%、30.48%、28.34%、23.13%、20.32%,而对利奈唑胺、替加环素、替考拉宁和万古霉素则是100.00%敏感。结论本院SA以及MRSA的检出率比较高,部分药物的耐药率也比较高,所以院感科要做好院内感染监测工作,临床科室要根据药敏结果合理使用抗生素。

Objective To analyze the characteristics of clinical distribution and drug resistance of all the staphylococcus aurei detected in our hospital in 2019,so as to provide basis for rational use of antibiotics in clinical practice and effective control of nosocomial infection.Methods Through retrospective analysis,the staphylococcus aurei detected in our hospital in 2019 were analyzed from the perspectives of department distribution,specimen source and drug resistance,etc.Results A total of 748 staphylococcus aureus strains were detected in 2019,including 173 methicillin-resistant staphylococcus aureus(MRSA)strains.Most of these strains were distributed in the Department of Pediatrics(28.21%),the Department of Burn and Plastic Surgery(25.53%),the Department of Dermatology(5.35%)and the Department of Orthopedic Traumatology(4.95%).As for the specimen sources,there were 383 strains from wound secretions,138 from throat swabs,78 from sputa,47 from blood,45 from pus,24 from urine,18 from umbilical discharge and 15 from other sources.The drug sensitivity results showed that the drug resistance rate of SA to penicillin was 87.97%,the drug resistance rates to azithromycin,clarithromycin,erythromycin,clindamycin,tetracycline,oxacillin and cefoxitin were respectively 47.06%,46.12%,46.12%,30.48%,28.34%,23.13%and 20.32%,and the drug resistance rates to linezolid,tigecycline,teicoplanin and vancomycin were 100%.Conclusion The detection rates of staphylococcus aureus and MRSA in our hospital are relatively high,and the drug resistance rates to some drugs are also relatively high.Therefore,the Nosocomial Infection Control Department should do a good job in monitoring nosocomial infection,and the clinical departments should use antibiotics rationally according to the drug sensitivity results.