深圳地区甲氧西林耐药葡萄球菌的耐药性调查

Investigation on antimicrobial resistance of methicillin-resistant staphylococci in Shenzhen area

目的 :了解深圳地区甲氧西林耐药葡萄球菌 (MRS)的耐药性及其在各临床科室的分布。方法 :采用高盐琼脂加苯唑西林纸片方法筛选MRS ,并用Kirby Bauer法对 70 2株临床分离的MRS作药敏试验。结果 :2 0 0 1年 8月— 2 0 0 3年 7月间我院临床分离出 879株葡萄球菌 ,共筛选出MRS 70 2株。其中凝固酶阴性葡萄球菌 6 99株 ,甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS) 6 13株 ,占 87.7% ,甲氧西林耐药金黄色葡萄球菌 (MRSA) 89株 ,占 4 9.4 %。MRCNS对万古霉素、替考拉宁和阿米卡星的耐药率低 (0 %～ 15 .3% ) ,对其余 7种抗菌药物的耐药率均较高 (36 .4 %～ 82 .9% )。MRSA对万古霉素和替考拉宁耐药率为 0 % ,对复方磺胺甲唑、氯霉素的耐药率也较低 (9.6 %～ 12 .5 % )。对其余 6种抗菌药物的耐药率高达 6 9.6 %～96 .4 %。结论 :本地区MRS的检出率高 ,MRS对多数抗菌素的耐药形势严峻 ,需引起医疗工作者的高度重视。

Objective: To investigate the resistance profile of methicillin-resistant staphylococci (MRS) to antimicrobial agents and the distribution of MRS in clinical departments in the hospital. Methods:MRS was detected by oxacillin-salt agar screening test. The susceptibility of 702 strains of MRS to antimicrobial agents was tested by Kirby-Bauer method. Results:MRS was detected in 702 (79.9%) of 879 strains of staphylococci collected from August 2001 to July 2003. Methicillin-resistant strains were isolated in 89 (49.4%) of 180 Staphylococcus aureus and 613 (87.7%) of 699 coagulase-negative staphylococci (CNS). Of 702 MRS strains, 40.5% were isolated from blood, 23.5% isolated from intensive care unit. All MRSA strains were susceptible to vancomycin and teicoplanin with low resistance rates of 9.6%-12.5% to trimethoprim-sulfamethoxazole and chloramphenicol, while the resistance rates to other 6 antimicrobial agents tested being between 69.6% and 96.4%. The resistance rates of MRCNS to vancomycin, teicoplanin and amikacin were low (0%-15.3%), while those to other 7 antimicrobial agents ranging from 36.4% to 82.9%. Conclusions:MRS is prevalent in staphylococci in Shenzhen area and MRS is highly resistant to most of the commonly used antimicrobials except vancomycin and teicoplanin.