金黄色葡菌萄球耐药性监测

Antimicrobial resistance of Staphylococcus aureus

目的 :监测成都市 4家三级甲等医院临床分离的金黄色葡萄球菌 (金葡菌 )耐药性。方法 :用琼脂稀释法测定 11种抗菌药物对 2 82株金葡菌的最低抑菌浓度 (MIC)值 ,并对菌株来源及科室分布进行分析。结果 :2 82株金葡菌共筛出耐甲氧西林金葡菌 (MRSA) 94株 ,检出率为 33.3% ;甲氧西林敏感金葡菌 (MSSA)共 188株。MSSA对青霉素和克拉霉素的耐药率分别为 71.3%和 5 4 .8% ,而对其他抗菌药物敏感。MRSA对万古霉素、阿米卡星和利福平敏感性高 (最强者为万古霉素 ) ,而对其余多种抗菌药物耐药。MRSA来源最多为痰 ,其次为各种分泌物 ;科室分布依次为烧伤科、重症监护病房 (ICU)、感染科等。结论 :青霉素、大环内酯类药物不宜用于金葡菌感染。MRSA具有多重耐药性。MRSA感染首选糖肽类抗生素治疗。金葡菌是一种重要的病原菌 ,应长期进行耐药性监测 。

Objective: To survey the bacterial resistance of the clinical isolates of Staphylococcus aureus isolated from Chengdu hospitals. Methods: The MICs of 11 antibiotics against 282 clinical isolates of Staphylococcus aureus were determined by agar dilution method, and the source and distribution of these strains were analyzed. Results: Nintey four MRSA were isolated and accounted for 33.3% of 282 isolates of Staphylococcus aureus. Among 188 MSSA strains, the resistance rates of penicillin and clarithromycin were 71.3% and 54.8% respectively, while most MSSA strains were sensitive to the other 9 antibiotics. All MRSA strains were sensitive to vancomycin and most of them were sensitive to aminoglycoside and rifampin, however, most of these strains were resistant to the other antibiotics. MRSA strains were mainly isolated from sputum and other exudates, and most were from burn unit, ICU and infectious diseases department. Conclusion: Penicillin and macrolides should not be used for the treatment of infections caused by S. aureus. MRSA were usually multi drug resistant. Glycopeptides are the first choice for the treatment of MRSA infections. In high risk departments such as burn and ICU should monitor the resistance of MRSA strains and pay great attention in sterilization, and isolation procedures.