摘要
目的:了解不同病区和标本中金黄色葡萄球菌的感染情况及其耐药性变化特别是ORSA的耐药情况。方法:应用MicroScanAutoScan-4专用PC12鉴定板检测210例金黄色葡萄球菌对18种的抗生素的敏感程度,根据仪器专家系统自动分析病原菌对抗生素的MIC浓度和β内酰胺酶阳性结果。结果:所有金黄色葡萄球菌菌株β内酰胺酶阳性,OR-SA菌株以白带最高(85·7%)、其次为精液(76·4%)、尿液(55·0%),伤口分泌物(31·2%)和脓液(5·3%)最低,门诊(标本主要为白带、精液等)、一般住院病人、ICU中ORSA菌株分离率分别为79·6、41·9、25·0%;ORSA菌株对氨苄西林、青霉素G耐药率99·2%,苯唑西林敏感金黄色葡萄球菌(OSSA)对氨苄西林、青霉素G耐药率也超过83·0%;ORSA菌株对诺氟沙星、环丙沙星、红霉素、克林霉素、庆大霉素等多种抗生素的耐药性高于OSSA菌株(P<0·001),并有耐万古霉素菌株的出现;不同病区来源的金黄色葡萄球菌对环丙沙星、红霉素、诺氟沙星、四环素、苯唑西林耐药率高低出现门诊、一般住院病人、ICU依次递减的现象(P<0·05);来自精液、痰液标本的金黄色葡萄球菌对环丙沙星、庆大霉素、苯唑西林的耐药率和白带标本中金黄色葡萄球菌对苯唑西林的耐药率明显高于脓液(P<0·05)。结论:来自社区感染金黄色葡萄球菌高ORSA分离率与标本来源有关,不同标本之间抗生素的敏感性存在差异性,ORSA与OSSA对抗生素耐药性不同。
Objective： To explore the isolation condilion and the drug resistance feature of S. aureus from different wards and specimens, especially the isolation condition of Oxacillin- resistant S. aureus （ORSA） strain. Methods： Bacteria isolated from 2004 to 2005 were identified by Micro - Scan AutoScan - 4. and the determination of bacterial antibiotic susecptibility were performed by the instrument expert system. Results： 210 strains of S. aureus were isolated, all the strains are producing β- lactams. As for different wards, the isolation rate of ORSA strain is 79.6% （outpatient wards）, 41.9% （common inpatient wards）, 25.0% （ICU） respectivdy, and the resistance rate of Erythomycin, Tetracyline, Gentamicin, clindamycin, Ciprofloxacin, Oxacillin are diminished sequentially among the outpatient wards, the common inpatient wards and ICU （P 〈 0. 001 ）. As for different specimens, the isolation rate of MRSA strain is 85.7% （vaginal excretion）, 76.4% （seminal fluid）, 55.0% （urine）, 31.2% （wound secretion）, 5.3% （abscess） respectively. In the strains from seminal fluid and sputum, the resistance rate of , Gentamicin, Ciprofloxacin, Oxalillin is apparently higher than that from abscess. Conclusion： The drug resistance of S. aureus differ among wards and specimens, the high isolation rate of ORSA strain from community acquired infection is relevant to the type of the specimens. The surveillance of the drug resistance feature of S. aureus from different wards and specimens will well serve the clinic for reasonable and effective utilization of antibiotics.
出处
《现代预防医学》
CAS
北大核心
2006年第10期1946-1949,共4页
Modern Preventive Medicine
关键词
苯唑西林耐药金黄色葡萄球菌
抗生素
耐药性
社区感染
Oxacillin- resistant S. aureus
antibiotic
drug resistance
community acquired infection
