摘要
目的了解医院2011年金黄色葡萄球菌的耐药性,为临床合理使用抗菌药物提供依据。方法采用纸片扩散法进行药敏试验,并采用Etest法测定万古霉素对耐甲氧西林金黄色葡萄球菌(MRSA)的最低抑菌浓度(MIC),以CLSI 2010年标准判断结果,WHONET5.6软件分析数据。结果全年共分离金黄色葡萄球菌255株,其中MRSA检出率为51.4%,以神经外科、ICU检出率最高,分别为85.4%、80.1%,门诊患者最低为15.2%;甲氧西林敏感金黄色葡萄球菌(MSSA)对青霉素高度耐药,对红霉素耐药率为41.7%,对其余抗菌药物均高度敏感,敏感率>70.0%;MRSA对抗菌药物的耐药率明显高于MSSA,MRSA除对万古霉素、替考拉宁、利奈唑胺敏感率100.0%外,对磺胺甲噁唑/甲氧苄啶、利福平敏感率分别为92.0%、80.4%;Etest结果显示MRSA对万古霉素MIC50和MIC90分别为1.0、2.0μg/ml,MIC>1.0μg/ml菌株所占比例为44.3%,未发现有万古霉素非敏感株。结论神经外科和ICU是MRSA感染的高危部门,MRSA对抗菌药物耐药性高,应重视MRSA万古霉素MIC的监测。
OBJECTIVE To investigate the drug resistance of Staphylococcus aureus in 2011 so as to provide basis for the rational use of antibiotics. METHODS The antimicrobial susceptibility testing was carried out by means of Kirby-bauer（KB） ,the minimum inhibitory concentration （MIC） of vancomyein for methicillin-resistant S. aureus （MRSA） was determined by using E test, and the data were analyzed by Whonet 5.6 software according to CLSI 2010 breakpoint. RESULTS A total of 255 strains of S. aureus were isolated, among which the MRSA strains accounted for 51. 4%. The highest prevalence of MRSA was found in neurosurgery ward （85. 4%）and ICU （80.1%）, the lowest in outpatient department （15. 2%）. The methicillin-sensitive S. aureus （MSSA） strains showed high degree of resistance to penicillin, and 41. 7% to erythromycin, highly sensitive to the rest of antibacterial drugs with the drug susceptibility rate higher than 70.0%. The resistance rate of the MRSA was significantly higher than that of the MSSA. The MRSA strains showed 100. 0% susceptible to vancomycin, linezolid and teicoplanin, followed by 92. 0% to sulfamethoxazole-trimethoprim and 80. 4% to rifampicin. The E-test results showed that the MICs0 and MIC90 of vancomycin against the MRSA strains were 1.0ug/ml and 2.0 ug/ml, respectively. 44.3% of the MRSA strains had a vancomycin MIC more than 1.0 ug/ml, but no strains of vancomycin-sensitive strains were found. CONCLUSION Neurosurgery ward and ICU have high prevalence of MRSA infection, MRSA strains were highly resistant to most antibiotic agents, the monitoring of vancomycin MIC for MRSA should be paid more attention.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第6期1428-1430,共3页
Chinese Journal of Nosocomiology
关键词
金黄色葡萄球菌
耐甲氧西林金黄色葡萄球菌
耐药率
Staphylococcus aureus
Methicilin-resistant Staphylococcus aureus
Antibiotics resistance rate
