Ophthalmic methicillin-resistant <i>Staphylococcus aureus</i>infections: Sensitivity and resistance profiles of 65 isolates in central California

Purpose: To capture the sensitivity and resistance trends of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a heterogenous demographic. Methods: Between 1/1/2004-12/31/2011, ophthalmic MRSA infections were searched in the electronic medical record system ofCommunityRegionalMedicalCenterinFresno,California. We reviewed whether the infection was community-acquired or hospital-acquired, culture site, and sensitivity/resistance profiles. Results: The ophthalmic MRSA isolates tested for vancomycin, sulfamethoxazole-trimethoprim, and gentamycin were 100% sensitive to these to these antibiotics. Tetracycline and rifampin had the next highest sensitivity to resistance ratio, followed by clindamycin. More cases were community-acquired than hospital acquired. Almost half of the hospital-acquired cases were in newborns. Most hospital acquired infections were post-ophthalmic surgery. Conclusion: There is an increasing trend of community- acquired ophthalmic MRSA infection with eyelid involvement being the most common manifestation. Hospital-acquired cases are common in newborns and post-ophthalmic surgery. Have a high index of suspicion for MRSA infection with suspected “insect bites”. Vancomycin, sulfamethoxazole-trimethoprim, gentamycin, tetracycline, and rifampin are good choices to treat ophthalmic MRSA infection. There may be emerging resistance to clindamycin, at least in theCentral Californiaregion. If MRSA infection is suspected, erythromycin and fluoroquinolones should be avoided.

Analysis of the Clinical Characteristics and Antibiotics Resistance of Community-acquired Methicillin-resistant Staphylococcus aureus

The purpose of this investigation is to study the clinical characteristics of infections by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and the condition of antibiotics resistance of the clinical isolates in order to guide for the rational use of antibiotics. With the clinical isolates from cases of hospital-acquired MRSA at the same period as controls, the clinical characteristics of infections by community-acquired MRSA in Hangzhou area and the pattern of non-β-lactamase antibiotics resistance were determined in this study. It was found that the average age of patients with community-acquired MRSA infections was 30.89±13.3, in comparison with those of the hospital-acquired patients of 56.0±11.8, appearing to be younger than those of the latter, and the former showing no any basic illness. Both of the former and the latter were sensitive to vancomycin (100% vs 100%), and they had the same degrees of sensitivity to rifampicin, fosfomycin, and STM/TMP (86.8% vs 88.1%, P >0.05; 81.6% vs 82.9%, P >0.05; and 52.6% vs 61.9%, P >0.05, respectively). The former was more sensitive to netimycin, clindamycin, erythromycin and minocycline than those of the latter (73.7% vs 50.5%, P <0.01; 60.5% vs 45.7%, P <0.05; 28.9% vs 11.4%, P <0.01; and 81.6% vs 58.6%, P <0.01 respectively). Meanwhile, the incidence of multi-resistant strain of isolates in the former was significantly lower than that of the latter (31.6% vs 81.0%, P <0.01). In conclusion, it appears that the strains of clinical isolates isolated from patients with the community-acquired MRSA infections show different clinical characteristics and antimicrobial susceptibility in comparison with those of the hospital-acquired cases of infection, and this necessitates an alteration in the chemotherapy of infections suspected to be caused by community-acquired MRSA.

Postoperation of preauricular fistula cellulitis caused by methicillin-resistant staphylococcus aureus infection

A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for the wound, presented with MRSA infection. The patient was treated with linezolid for three days. Her pain and paresthesia resolved, and C-reactive protein decreased to normal.

Community-acquired multidrug-resistant pneumonia,bacteraemia,and infective endocarditis:A case report

BACKGROUND The prevalence of multidrug-resistant(MDR)bacteria has increased globally,with extensive drug-resistant(XDR)bacteria posing a threat to patients.CASE SUMMARY This case report describes a young man admitted for suspected tropical fever infections who experienced rapid deterioration in health.Despite negative results for tropical fever infections,he had neutrophilic leucocytosis,acute kidney injury,and chest imaging findings suggestive of bilateral consolidations.On day two,he was diagnosed with infective endocarditis with possible rheumatic heart disease and MDR methicillin-resistant Staphylococcus aureus bacteraemia,and communityacquired pneumonia.Despite treatment with broad-spectrum antibiotics,he did not respond and succumbed to death on day five.CONCLUSION This case highlights that clinicians/public should be aware of MDR communityacquired pneumonia,bacteraemia,and endocarditis which ultimately culminate in high rates of morbidity and mortality.Early identification of pathogenic strain and prompt antibiotic treatment are a mainstay for the management and prevention of early fatalities.Simultaneously,route cause analysis of communityacquired MDR/XDR pathogens is a global need.

A case of methicillin-resistant Staphylococcus aureus infection following bile duct stenting

AIM: To present a case of methicillin-resistant Staphylococcus aureus (MRSA) infection following bile duct stenting in a patient with malignant biliary obstruction.METHODS: A 78-year-old male patient was admitted to a community hospital with progredient painless jaundice lasting over two weeks, weight loss and sweating at night.Whether a stent should be implanted pre-operatively in jaundiced patients or whether these patients should directly undergo surgical resection, was discussed.RESULTS: ERC and a biopsy from the papilla of Vater revealed an adenocarcinoma. In addition, a 7-Ch plastic stent was placed into the common bile duct. Persistent abdominal pain, increasing jaundice, weakness and indigestion led to the transfer of the patient to our hospital.A pylorus-preserving pancreatoduodenectomy wasperformed. Intraoperatively, bile leaked out of the transected choledochus andthe stent was found to be dislocated in the duodenum. A smear of the bile revealed an infection with MRSA, leading to post-operative isolation of the patient.CONCLUSION:As biliary stents can cause severe infection of the bile, the need for pre-operative placement of biliary stents should be carefully evaluated in each individual case.

Detection and Characterization of Methicillin Resistant Staphylococcus aureus from Toilet and Classroom Door Handles in Selected Secondary Schools in Nairobi County

Background: Staphylococcus aureus is found on all surfaces especially in public areas like hospitals and schools and on frequently touched areas like toilet and classroom door handles. Methicillin resistant Staphylococcus aureus (MRSA) is a strain of Staphylococcus aureus which is resistant to methicillin. There are two types of MRSA: Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) and hospital acquired methicillin resistant Staphylococcus aureus (HA-MRSA). MRSA in the community presents a significant reservoir that could enter into healthcare facilities and spread among patients and also a risk for immune compromised persons in the community. Methodology: The study aimed at determining the prevalence of MRSA isolated from toilet and classroom door handles as a potential source of infection to the students and the workers in selected schools in Nairobi, Kenya. The study also compared the prevalence of MRSA between boarding and non-boarding girls, boys and mixed (both girls and boys in the same school) secondary schools. Twelve secondary schools in Nairobi County were randomly selected and 306 samples from both the toilet and classroom door handles were collected using sterile swabs and transported to the laboratory. Isolation of Staphylococcus aureus was done by the use of selective media Mannitol salt agar, antibiotic susceptibility of isolates was done by disk diffusion method, and molecular detection of mecA and PVL genes were done by polymerase chain reaction (PCR). Results: The prevalence of S. aureus was 20% and 15% were MRSA positive by both Antimicrobial Susceptibility Test and PCR detection. 20% showed the presence of PVL genes, 8% showed the presence of both genes and 56% of isolates with mecA gene had PVL genes. Conclusion: The presence of MRSA in this study emphasizes the need to formulate hygiene measures to prevent possible spread of MRSA and other transmissible pathogens to students and workers in the schools.

Change in drug resistance of staphylococcus aureus

Objective To analyze the change in drug resistance of staphylococcus aureus(SAU) in the PLA general hospital from January 2008 to December 2012, and to provide solid evidence to support the rational use of antibiotics for clinical applications. Methods The SAU strains isolated from clinical samples in the hospital were collected and subjected to the Kirby-Bauer disk diffusion test. The results were assessed based on the 2002 American National Committee for Clinical Laboratory Standards(NCCLS) guidelines. Results SAU strains were mainly isolated from sputum, urine, blood and wound excreta and distributed in penology, neurology wards, orthopedics and surgery ICU wards. Except for glycopeptide drugs, methicillinresistant staphylococcus aureus(MRSA) had a higher drug resistance rate than those of the other drugs and had significantly more resistance than methicillin-sensitive staphylococcus aureus(MSSA)(P<0.05). In the dynamic observation of drug resistance, we discovered a gradual increase in drug resistance to fourteen test drugs during the last five years. Conclusion Drug resistance rate of SAU stayed at a higher level over the last five years; moreover, the detection ratio of MRSA keeps rising year by year. It is crucial for physicians to use antibiotics rationally and monitor the change in drug resistance in a dynamic way.

Community-acquired pneumonia:The importance of the early detection of drug-resistant organisms

Pneumonia is a disease associated with significant healthcare burden with over 1.5 million hospitalizations annually and is the eighth leading cause of death in the United States.While community-acquired pneumonia(CAP)is generally considered an acute time-limited illness,it is associated with high long-term mortality,with nearly one-third of patients requiring hospitalization dying within one year.An increasing trend of detecting multidrug-resistant(MDR)organisms causing CAP has been observed,especially in the Western world.In this editorial,we discuss about a publication by Jatteppanavar et al which reported that a case of a MDR organism was the culprit in developing pneumonia,bacteremia,and infective endocarditis that led to the patient’s death.The early detection of these resistant organisms helps improve patient outcomes.Significant advances have been made in the biotechnological and research space,but preventive measures,diagnostic techniques,and treatment strategies need to be developed.

Treatments and limitations for methicillin-resistant Staphylococcus aureus: A review of current literature

Methicillin-resistant Staphylococcus aureus(MRSA)has remained a major threat to healthcare;in both hospital and community settings over the past five decades.With the current use of antibiotics for a variety of infections,including MRSA,emerging resistance is a major concern.Currently available treatments have restrictions limiting their use.These issues include,but are not limited to,side effects,cross-resistance,lack of understanding of pharmacokinetics and clinical pharmacodynamics,gradual increment in minimal inhibitory concentration over the period(MIC creep)and ineffectiveness in dealing with bacterial biofilms.Despite availability of various therapeutic options for MRSA,the clinical cure rates remain low with high morbidity and mortality.Given these challenges with existing treatments,there is a need for development of novel agents for MRSA.Along with prompt infection control strategies and strict implementation of antibiotic stewardship,cautious use of newer anti-MRSA agents will be of utmost importance.This article reviews the treatments and limitations of MRSA management and highlights the future path.

<i>In Vitro</i>Activities of Mupirocin, Tigecycline, Ceftaroline, Vancomycin, Linezolid and Daptomycin in Clinical Isolates of Methicillin-Resistant <i>Staphylococcus aureus</i>by E-Test Methodology

Introduction: In 2013, the Center for Disease Control (CDC) designated methicillin-resistant Staphylococcus aureus (MRSA) as a serious threat. In addition to its intrinsic virulence, MRSA has become resistant to numerous antibacterial agents. In many instances, mupirocin is used empirically to decolonize patients harboring MRSA to decrease the possibility of progression to disease. In vitro susceptibility information is critical to identify patients who would benefit from use of mupirocin for decolonization and treatment of infections caused by MRSA. Methods: One-hundred and sixty-three recent MRSA single patient clinical isolates were collected from the Clinical Microbiology Laboratory. In-vitro susceptibility testing was performed using E-test methodology for tigecycline, ceftaroline, daptomycin, vancomycin, linezolid, and mupirocin. Results: Of the 163 MRSA isolates tested, >99% demonstrated susceptibility to tigecycline, ceftaroline, daptomycin, vancomycin, and linezolid. Seventy (43%) had vancomycin MICs ≥ 1.5 μg/ml, twenty-four isolates (15%) were resistant to mupirocin, and three appeared to express mupirocin hetero-resistance. Conclusion: While antibiotic susceptibility to mupirocin is not routinely performed in clinical microbiology laboratories, the level of resistance to mupirocin identified in this surveillance study suggests that susceptibility testing should be added to routine MRSA panels.

Multidrug-resistant bacterial infections after liver transplantation: An ever-growing challenge

Bacterial infections are a leading cause of morbidity and mortality among solid organ transplant recipients.Over the last two decades,various multidrug-resistant(MDR)pathogens have emerged as relevant causes of infection in this population.Although this fact reflects the spread of MDR pathogens in health care facilities worldwide,several factors relating to the care of transplant donor candidates and recipients render these patients particularly prone to the acquisition of MDR bacteria and increase the likelihood of MDR infectious outbreaks in transplant units.The awareness of this high vulnerability of transplant recipients to infection leads to the more frequent use of broad-spectrum empiric antibiotic therapy,which further contributes to the selection of drug resistance.This vicious cycle is difficult to avoid and leads to a scenario of increased complexity and narrowed therapeutic options.Infection by MDR pathogens is more frequently associated with a failure to start appropriate empiric antimicrobial ther-apy.The lack of appropriate treatment may contribute to the high mortality occurring in transplant recipients with MDR infections.Furthermore,high therapeutic failure rates have been observed in patients infected with extensively-resistant pathogens,such as carbapenemresistant Enterobacteriaceae,for which optimal treatment remains undefined.In such a context,the careful implementation of preventive strategies is of utmost importance to minimize the negative impact that MDR infections may have on the outcome of liver transplant recipients.This article reviews the current literature regarding the incidence and outcome of MDR infections in liver transplant recipients,and summarizes current preventive and therapeutic recommendations.

Prevalence and Antimicrobial Susceptibility Pattern of Methicillin Resistance Staphylococcus in a Sudanese Surgical Ward

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is important nosocomial pathogen. Aim: In this paper, we determined the prevalence and the antibiotic susceptibility pattern of (MRSA) in a Sudanese surgical ward. Method: A total of 200 post-operative surgical specimens were collected from patients hospitalized in gastrointestinal tract (GIT) surgical ward in Ibn Sina hospital, Khartoum, Sudan and were subjected to MRSA screening and sensitivity test. Key findings: Out of 35 strains of Staphylococcus aureus isolated from surgical samples, 25 (71.4%) were found to be MRSA. Almost all MRSA strains were resistance to Methicillin, 96% to Ofloxacin, 92% to Pencillin G, 24% to Amikacin and 4% to Vancomycin. Cross-resistance was obviously detected. Conclusion: The present study detected alarming levels of S. aureus (MRSA) isolates, at the same time presence of high cross-resistance to other antibiotics.

Characterization of <i>Staphylococcus aureus</i>infections among children in an outpatient clinic, China

Objective: We aimed to investigate the epidemiology and identify antibiotic resistance patterns of isolates from children with skin and soft tissue infections attending an outpatient clinic in Southern China. Method: An observational study of outpatient pediatric patients was conducted in a rural area of Guangxi. Infections were characterized in 230 patients and staphylococcal isolates tested for susceptibility to a range of antibiotics. Results: Among the 307 patients, 38.5% were infants. Culture yielded Staphylococcus aureus (S. aureus) in 230 patients, of which 24 (10.4%) were methicillin-resistant S. aureus (MRSA). Staphylococcal strains were most isolated from hand, foot and umbilicus. The 1-12 mon group had the highest staphylococcal infection rate (86%), followed by the 6-12 year group, but MRSA was more common in the older children (19.5% of S. aureus). MRSA had significantly more resistance than MSSA to chloromycin (46% vs 11%), clindamycin (67% vs 19%), gentamicin (33% vs 2%), rifampicin (25% vs 2.9%), and sulphamthoxazole-trimethoprim (17% vs 3%). Conclusion: S. aureus remains a leading cause of pediatric skin and soft tissue infections. Over 10% of isolates were methicillin-resistant with high rates of resistance to non-beta lactam antibiotics, reducing options for therapy and limiting choices for empirical treatment.

Comparative Antibiotic Sensitivity Pattern of Hospital and Community Acquired <i>Staphylococcus aureus</i>Isolates of Jessore, Bangladesh

Staphylococcus aureus has emerged over the past several decades as a leading cause of hospital acquired infections, which are more commonly termed as nosocomial infections. In recent years, strains of this bacterium which are resistant against several types of antibiotics have evolved and their prevalence is becoming a potential epidemiological threat. As there are limited data available on antibiotic resistance patterns of S. aureus that are isolated from hospital, the study was undertaken. The study was conducted by collecting swab samples from the hospital environment & volunteers and then identified them by standard methods. In case of hospital isolates, highest percentage of resistance was shown against Erythromycin (88.89%) and Ampicillin (83.33%). Significant resistance was also observed in cases of Ciprofloxacin (33.33%) and Tetracycline (33.33%). Lowest percentage of resistance was shown against Streptomycin (11.11%) and Vancomycin shows only intermediate resistant pattern (11.11%). On the other hand, community isolates were 100% sensitive against four antibiotics except Ampicillin (60% resistant) and Vancomycin (20% resistant). From the result it is easily discernable that, there are significant differences in the resistance pattern among hospital environment isolates and community acquired isolates. Samples were collected from different locations of hospital surgery room e.g. floor, wall, operating bed, trolley, sitting tool, cabinet etc. As anticipated, highest number of isolates showing resistance against these antibiotics were from the tool used for sitting.

Effect of Photoactivated Hypericin on Growth and Antibiotic Susceptibility of Hospital-Related Staphylococcus aureus and Enterococcus sp. Clinical Strains

Resistance against commonly used antibiotics is a serious clinical problem in recent medical practice. There exist several bacterial strains in which the possibilities of their inhibition are very limited due to multidrug resistance. Antimicrobial photodynamic therapy (aPDT) represents an option how to effectively suppress the growth of resistant pathogens. In this work we have studied interactions of potent photosensitizer hypericin (Hyp) with hospital-related gram positive (Gram+) and gram negative (Gram-) bacterial strains and the effects of photodynamic activated Hyp on bacterial susceptibility and/or resistance of these strains to antibiotics. We demonstrated a significant influence of photoactivated Hyp on growth of Staphylococcus aureus and Enterococcus sp. We have also shown that it is extremely important to use the effective concentrations of Hyp for aPDT, which completely inhibit the growth of microorganisms. Otherwise, there appears an increase in resistance, probably due to the activation of efflux mechanisms, which are involved in the efflux of Hyp and antibiotics as well.

Epidemiology of methicillin-resistant Staphylococcus aureus infection and empirical antibiotic therapy for MRSA infection： multicenter investigation

Background The epidemiology of methicillin-resistant Staphylococcus aureus （MRSA） maybe changed by strict infection control measures,and the impact of empirical antibiotic therapy on the outcomes of MRSA infection was not clear.We aimed to investigate the present epidemiological status of MRSA infection and empirical antibiotic therapy for MRSA infection in university teaching hospitals in China's Mainland.Methods The present study was a multicenter prospective observational study conducted in five university teaching hospitals.Patients who were consecutively admitted to the intensive care unit and signed a consent form from March 3,2011 to May 31,2011 were included.Patients with age 〈18 years or with a length of hospital stay 〈48 hours were excluded from this study.The following variables were collected or recorded：demographic data,general status,APACHE Ⅱ score of the patient at the time of admission,infections,and the use of antibiotics during a stay.Primary outcomes and prognostic indicators included length of hospital stay and 28-day and 90-day mortality.The differences between the patients with appropriate empirical therapy and patients with inappropriate therapy were analyzed to detect the influences of antibiotic therapy on the prognosis of MRSA infection.Results A total of 682 cases were enrolled.Thirty （66.2%） of 88 MRSA cases were treated with effective antibiotics for MRSA infection; only 20% received appropriate empirical antibiotic treatment.The empirical therapy group compared with the target therapy group had a shorter length of stay,but there were no significant differences in mortality rates.There were no significant differences in the length of hospital stay,length of stay,and 28-day and 90-day mortality between MRSA-infected patients who received or not received effective antibiotics.Two hundred and eighteen cases received sensitive antibiotics for MRSA.Conclusions The MRSA infection rates are at relatively low levels in university teaching hospitals in China.The empirical use of sensitive antibiotics for MRSA infection was at relatively high rate,and there is a tendency of overusing in patients without MRSA infection.On the other hand,the rate of appropriate empirical antibiotic therapy for patients with MRSA infection is relatively low.

Gene typing and antibiotic resistance of methicillin- resistant Staphylococcus aureus isolated from lower respiratory tract at two hospitals in Shanghai

Objective To study the genotyping characteristics and antibiotic resistance of methicillin-resistant Staphylococcus aureus(MRSA)isolated from lower respiratory tract at 2 different level hospitals in Shanghai.Methods The subjects included 155 patients at Ruijin Hospital and Tongren Hospital between January 2013 and June 2014,including 108 males and 47 females,with a mean age

Super Antibiotics, Part II. Hyperforin, Mass Spectroscopy (MS) and Gas Chromatography-Mass Spectrometry (GC-MS), Evidence of Permeability of the Blood-Testis Barrier (BTB) and the Blood-Brain Barrier (BBB) to Hyperforin

In the first article of this series, we presented some evidence of hyperforin as an antibiotic, antiprotozoal, antiviral, anticancer, and immunomodulatory substance. In the present article, evidence of the permeability of the blood-testis barrier (BTB) and blood-brain barrier (BBB) to hyperforin and its distribution in other organs of the domestic pig (Sus scrofa domesticus) are revealed. Seven-month-old male boars with a body mass of 100 kg were fed a diet containing hyperforin. Organs were surgically removed under anesthesia. Organs were suitable prepared and extracted, and then analyzed using gas chromatography-mass spectrometry with supersonic molecular beams (GC-MS with SMB). The presence of hyperforin was recorded in all organs and body fluids. Special attention was paid to the evaluation of the presence of hyperforin in the brain and testes of experimental animals. The presence of hyperforin in the brain and testes of experimental animals was established by GC-MS with SMB. The results are of interest because penicillin and numerous other antibiotics cannot pass through the BTB or BBB if healthy or non-inflamed, which limits their use in patients with meningitis and gonorrhea. The findings are also of interest in cases of penicillin- and multi-antibiotic-resistant bacterial infections.

Protection Against Lethal Multidrug-Resistant Bacterial Infections Using Macrophage Cell Therapy

Multidrug-resistant(MDR)bacterial infections exert a tremendous burden on the public health system throughout the developing and developedworld.Slowing development of novel antibiotic scaffolds,over-prescription of antibiotics,extensive agricultural antibiotic use,and the increasingly complex hospitalized patient populations undergoing treatment,all fuel the rise of highly MDR“superbugs.”Unfortunately,host-directed therapies to boost immune resistance to infection are not currently available for treatment of MDR pathogens.Hematopoietic cells are endowed with a variety ofmechanismsto control microbial invasion.Macrophages in particular have long been appreciated as potent antimicrobial immune cells equipped with several receptors that allow for rapid recognition,phagocytosis,and killing of pathogenic microbes,coupled to secretion of immunostimulatory cytokines to further orchestrate a robust multifaceted antibacterial immune response.To investigate the utility of macrophages as a cell therapy for MDR bacterial infections,we developed a therapeutically translatable process to generate,harvest,and cryopreserve monocyte-derived macrophages(ICONIMACTM).These cells effectively killed both Gram-positive and Gram-negative MDR pathogens in vitro,and conferred protection in vivo against experimental lethal peritonitis and lung infection.Our discoveries provide a proof-of-concept for a novel immunotherapeutic approach against MDR bacterial infections,urgently needed to supplement the diminishing antibiotic pipeline.

骨折内固定术后感染金黄色葡萄球菌患者的耐药监测及临床分析

目的 分析金黄色葡萄球菌在骨折内固定术后感染患者中的耐药情况。方法 回顾性分析四川省骨科医院2016年1月至2020年12月骨折内固定术后确诊为金黄色葡萄球菌感染的临床病例,共收集金黄色葡萄球菌467株。根据药物敏感性实验分为耐甲氧西林金黄色葡萄球菌(MRSA)组(145株)和甲氧西林敏感金黄色葡萄球菌(MSSA)组(322株),分析比较2组对常见抗菌药物的耐药情况。统计2016—2020年万古霉素对MRSA最低抑菌浓度(MIC)。结果 金黄色葡萄球菌对青霉素的耐药率达94.9%(443/467),对红霉素、克林霉素、苯唑西林、四环素耐药率较高,对左氧氟沙星、利福平、复方磺胺甲噁唑片、莫西沙星的耐药率较低[8.4%(39/467)、5.8%(27/467)、3.6%(17/467)、3.0%(14/467)],未发现对万古霉素、利奈唑胺、达托霉素耐药的菌株,万古霉素中介3株。MRSA组和MSSA组对克林霉素、苯唑西林、红霉素、左氧氟沙星、莫西沙星、青霉素、利福平、复方磺胺甲噁唑片、四环素的耐药率比较差异均有统计学意义(均P<0.05)。万古霉素对MRSA的MIC为2 mg/L的比例较高。结论 金黄色葡菌球菌引起的骨折内固定术后感染MRSA检出率较高,万古霉素MIC=2 mg/L的比例较高,降低了万古霉素治疗骨折内固定术后感染的达标率,且万古霉素骨组织渗透率不高,增加了临床治疗难度。因此万古霉素骨水泥植入,联合万古霉素静脉用药,或万古霉素静脉用药与利福平、喹诺酮类、磺胺类、利奈唑胺等联合用药可能是治疗骨折内固定术后感染的较好选择。