葡萄球菌属对常用抗生素耐药情况调查

Survey on drug resistance of Staphylococcus to commonly used antibiotics

目的了解葡萄球菌属,特别是耐甲氧西林葡萄球菌(MRS)的耐药情况,为临床用药提供参考.方法从2002年1～7月送检的住院病人的血、痰、脓液、分泌物等标本中分离出的金黄色葡萄球菌、表皮葡萄球菌及其他血浆凝固酶阴性的葡萄球菌共105株,并进行药敏和多重耐药分析.结果MRS的分离率较高,为68.6%,耐甲氧西林金黄色葡葡球菌(MRSA)为69.2%;耐甲氧西林表皮葡萄球菌(MRSE)为63.3%.MRS较非耐甲氧西林葡萄球菌(MSS)耐药率明显高,且MRS比MSS多重耐药率高得多;MRSA对四种不同作用机制的抗生素:泰能、阿米卡星、环丙沙星、复方新诺明具有很高的多重耐药率,达到50%以上.结论鉴于MRS的高分离率和多重耐药率,在治疗感染性疾病时,应加强病原学检查,提高标本鉴定的阳性率;在有效的治疗MRS感染的同时还应注意遏制MRS的产生.

Objective To obtain primary knowledge of drug resistance of Staphylococcus, especially methicillin-resistant Staphylococcus(MRS), so as to facilitate clinical decision over the choice of appropriate antibiotics. Methods A total of 105 strains of Staphylococcus aureus, Staphylococcus epidermidis and other coagulase-negative Staphylococcus,were isolated from blood, sputum, pus and secretion sample from in-patients of Nanfang Hospital from January to July, 2002, and their status of drug-resistance was examined. Results MRS was isolated from 68.8% of the samples, and 69.6% of these isolates were methicillin-resistant Staphylococcus aureus(MRSA) and 63.3% resistant Staphylococcus epidermidis(MRSE). The rate of multi-drug resistance for MRS was much higher than that for methicilllin-susceptible Staphylococcus(MSS), and MRSA showed high multidrug resistance rates (all>50%) to the antibiotics erythromycin, imipenem, amikacin, SXT, ciprofloxacin, which fell into 4 categories according to their different antibiotic mechanisms. Conclusion The prevalence and high MDR rate of MRS isolated form the samples suggest that in cases of infection, identification of the pathogenic bacterium should be routinely performed. Besides controlling MRS infection, importance should also be given to its prevention.