摘要
目的调查医院金黄色葡萄球菌(SAU)临床分离和分布情况及其对常用抗菌药物的耐药率,分析SAU耐药性变迁,并比较儿科组和重症监护病房(ICU)、耐甲氧西林金黄色葡萄球菌(MRSA)和甲氧西林敏感金黄色葡萄球菌(MSSA)耐药率,为临床合理使用抗菌药物提供依据。方法对浙江萧山医院2006年1月至2010年12月检出的SAU药敏结果回顾性分析。结果共检出SAU 857株,菌株的主要来源为痰213株(24.9%)、脓液189株(22.1%)、泌尿生殖道分泌物166株(19.4%);菌株分布前3位的科室是妇产科165株(19.3%)、儿科155株(18.1%)、ICU 103株(12.0%);其中MRSA 252株(29.4%)。SAU对利奈唑胺、万古霉素和呋喃妥因具有很高的敏感性,未检出万古霉素耐药株;氨苄西林/舒巴坦和莫西沙星的耐药率呈上升趋势;MRSA对青霉素、苯唑西林、头孢唑林、氨苄西林/舒巴坦、庆大霉素、利福平、左旋氧氟沙星、莫西沙星、呋喃妥因、克林霉素、红霉素和四环素耐药率都明显高于MSSA耐药率,差异有统计学意义(P<0.01);ICU检出的SAU抗菌药物耐药率至少五类都明显高于儿科,差异有统计学意义(P<0.01)。结论 MRSA检出率升高,应加强对SAU检测及其耐药性监测;通过分析SAU耐药率的变迁,有利于采取措施控制医院内MRSA的流行和指导临床用药。
Objective To understand the distribution and drug resistance characteristics of Staphylococcus aureus in our hospital, compare the resistant rates of methicillin resistant Staphylococcus aureu （MRSA） and methicillin sensitive staphylococcus aureus （MSSA） to common antibiotics in pediatric ward and ICU and provide evidence for rational clinical use of antibiotics. Methods The surveillance data of Staphylococcus aureu from January 2006 to December 2010 were analyzed retrospectively. Results A total of 857 strains of Staphylococcus aureus were isolated from patient＇s sputum （24. 9% ）, pus （22. 1% ） and genital secretions （19.4%）, which were mainly distributed in gynecology and obstetrics ward （ 19. 3% ） ,pediatrics ward （ 18.1% ） and ICU （ 12. 0% ）. Among these isolates, 252 （29.4 % ） were MRSA. Staphylococcus aureus strains were highly sensitive to linezolid, vancomycin and nitrofurantoin. No vancomycin-resistant strain was found. The resistant rates to ampiciUin - sulbactam and moxifloxacin were in increase. The resistant rates of MRSA to penicilin, oxacillin, cefazolin, ampicillin - sulbactam, gentamycin, rifampin, levofloxacin, moxifloxacin, nitrofurantoin, clindamycin, erythromycin and tetracyclinewere obviously higher than those of MSSA, the differences were statistically significant （P 〈 0. 01 ）. The resistant rates of Staphylococcus aureus to at least 5 antibiotics in ICU were higher thanthose in pediatric ward, the differences were statistically significant （ P 〈 0. 01 ）. Conclusion Clinical isolation rate of MRSA was in increase. It is necessary to strengthen the surveillance of Staphylococcus aureus and its drug resistance for the effective control of MRSA circulation in hospital and rational clinical antibiotic use.
出处
《疾病监测》
CAS
2012年第2期117-120,共4页
Disease Surveillance
关键词
耐甲氧西林金黄色葡萄球菌
耐药性
临床分离
methicillin resistant Staphylococcus aureu
antibiotic resistance
clinical isolation
