914株金黄色葡萄球菌耐药性及耐药变迁分析

Analysis of Drug Resistance and Its Variation of 914 Strains of Staphylococcus Aureus

目的:对笔者所在医院914株金黄色葡萄球菌耐药性及耐药变迁进行分析,为临床治疗金黄色葡萄球菌感染提供依据。方法:选取笔者所在医院2013年1月-2018年12月微生物室分离菌株,应用VITEK-2Compact全自动微生物分析系统和WHONET 5.6软件分析金黄色葡萄球菌耐药性及耐药变迁。结果:共分离914株金黄色葡萄球菌,主要分离自患者分泌物31.2%(285/914)、痰液27.6%(252/914)、脓液23.7%(217/914);耐甲氧西林金黄色葡萄球菌(MRSA)检出率为39.2%(358/914),其中,痰液MRSA检出率最高,为48.0%(121/252)。金黄色葡萄球菌主要来源于疮疡科17.3%(158/914)、肛肠科11.8%(108/914);肺病科的MRSA检出率最高,为65.0%(39/60)。金黄色葡萄球菌对环丙沙星、利福平等敏感性较好,对青霉素敏感性最差,未见对利奈唑胺、万古霉素和奎奴普丁/达福谱汀耐药情况。甲氧西林敏感金黄色葡萄球菌(MSSA)对常用抗菌药物敏感性较好,且MSSA对抗生素的敏感性高于MRSA,6年间金黄色葡萄球菌对各类抗生素的耐药性无明显变化。结论:临床MRSA检出率较高,应加强金黄色葡萄球菌耐药检测,根据药敏合理用药,同时应加强院感监测,防止医源性的传播.

Objective:To analyze the drug resistance and variation of 914 strains of Staphylococcus aureus in our hospital,so as to provide evidence for clinical treatment of Staphylococcus aureus infection.Method:The strains isolated from the microbial laboratory of our hospital from January 2013 to December 2018 were selected and analyzed by VITEK-2 compact automatic microbiological analysis system and WHONET 5.6 software for drug resistance and drug resistance variation of Staphylococcus aureus.Result:A total of 914 strains of Staphylococcus aureus were isolated,mainly from patients’secretions 31.2%(285/914),sputum27.6%(252/914),pus 23.7%(217/914),Methicillin-resistant Staphylococcus aureus(MRSA)detection rate was 39.2%(358/914),of which sputum MRSA detection rate was the highest of 48.0%(121/252).Staphylococcus aureus mainly came from sores and ulcers department 17.3%(158/914),anorectal department 11.8%(108/914),and pulmonary department had the highest detection rate of MRSA with 65.0%(39/60).Staphylococcus aureus was more sensitive to Ciprofloxacin and Rifampicin than to Penicillin.No resistance to Linezolid,Vancomycin and Quinopristine/Dafoptine was found.Methicillin-sensitive Staphylococcus aureus(MSSA)was more susceptible to commonly used antibiotics,and MSSA was more susceptible to antibiotics than MRSA.The resistance of Staphylococcus aureus to various antibiotics had not changed significantly in six years.Conclusion:The detection rate of MRSA in clinic is high.It is necessary to strengthen the detection of drug resistance of Staphylococcus aureus,rational drug use according to drug sensitivity,and strengthen nosocomial surveillance to prevent iatrogenic transmission.