2017-2019年内蒙古包头地区金黄色葡萄球菌耐药监测结果分析

Analysis of the results of antimicrobial resistance surveillance of Staphylococcus aureus in Baotou,Inner Mongolia from 2017 to 2019

目的:了解内蒙古包头市11所三级医院金黄色葡萄球菌(staphylococcus aureus,SAU)的临床分布与耐药情况,为指导临床防控和诊治金黄色葡萄球菌感染提供依据。方法:收集包头市2017年1月-2019年12月11所参加全国耐药监测网的三级医院的金黄色葡萄球菌,利用SPSS 22.0及WHONET 5.6软件对数据进行分析。结果:共分离出病原菌21989株,其中金黄色葡萄球菌2562株,分离率为11.7%;检出MRSA 343株,占比为13.4%。参与统计的2562株金黄色葡萄球菌,标本类型依次为分泌物1025株(40.0%)、痰液562株(21.9%)、脓液210株(8.2%)、血液163株(6.4%),且痰液和血液中MRSA检出率最高为16.7%,脓液MRSA检出率最低为10.5%。不同标本类型MRSA对青霉素G、红霉素以及克林霉素耐药率均高于72%,未发现对万古霉素、利奈唑胺、替考拉宁耐药的菌株。不同标本类型MRSA对莫西沙星、环丙沙星、复方新诺明、左氧氟沙星、利福平、庆大霉素的耐药率差异有统计学意义(P<0.05)。结论:包头地区在金黄色葡萄球菌感染控制方面取得较大进展,MRSA的检出率较低,因此在临床治疗中要不断加强对MRSA的耐药性监测,合理使用相应抗菌药物。

Objective:To investigate the clinical distribution and drug resistance of Staphylococcus aureus(SAU)in 11 tertiary hospitals in Baotou,Inner Mongolia,so as to provide basis for clinical prevention,control,diagnosis and treatment of SAU infection.Methods:SAU was collected from 11 hospitals participating in the national drug resistance surveillance network in Baotou from January 2017 to December 2019,and the data were analyzed by SPSS 22.0 and WHONET 5.6 software.Results:A total of 21989 strains of pathogens were isolated from 2017 to 2019,including 2562 strains of SAU,with an isolation rate of 11.7%.343 strains of MRSA were detected,accounting for 13.4%.Among the 2562 strains of SAU involved in the statistics,the sample types were secretion 1025(40.0%),sputum 562(21.9%),pus 210(8.2%),and blood 163(6.4%).The highest detection rate of MRSA in sputum and blood was 16.7%,and the lowest detection rate of MRSA in pus was 10.5%.The resistance rates of different specimen types of MRSA to penicillin G,erythromycin and clindamycin were higher than 72%,and no strains resistant to vancomycin,linezolid and teicoplanin were found.There were significant differences in drug resistance rates of MRSA to moxifloxacin,ciprofloxacin,sulfamethoxazole,levofloxacin,rifampicin and gentamicin(P<0.05).Conclusion:Great progress has been made in the infection control of SAU in Baotou area,and the detection rate of MRSA is relatively low,so it is necessary to strengthen the monitoring of drug resistance of MRSA in clinical treatment and make rational use of corresponding antibiotics.