摘要
目的研究成都地区2013-2014年耐甲氧西林金黄色葡萄球菌（MRSA）的临床分布特征及耐药现状,为本地区临床抗菌药物的合理选择以及今后MRSA的动态监测提供重要依据。方法收集成都地区2013-2014年3家三甲医院临床分离的86株MRSA,经菌株鉴定及药敏试验后,进行临床分布及耐药性监测,并与112株非耐甲氧西林金葡菌（MSSA）对比。结果在86株MRSA中来自呼吸道标本所占比例最高（60.5%）,科室来源主要为ICU和呼吸内科;MRSA与同期随机抽取的MSSA对多种抗菌药物的耐药率有显著的统计学差异（P〈0.01）;多重耐药MRSA菌株占87.2%,共有22种联合耐药模式;ICU内MRSA对多数抗菌药物的耐药率高于非ICU（P〈0.05）;MRSA对大多数抗菌药物呈不同程度耐药,且体外抗菌活性差异较大;万古霉素MIC值为2mg/L的MRSA占7.0%。结论应尽早对ICU、呼吸内科65岁以上的老年肺部感染患者进行MRSA的主动筛查,以期早期诊断、隔离治疗。成都地区现阶段绝大多数MRSA具有多重耐药性,且对大多数抗菌药物耐药性严重;加强对ICU内MRSA的耐药性监测及控制工作;应动态监测本地区万古霉素对MRSA菌株的MIC值。
Obiective In order to provide important reference for reasonable choice of clinical antimicrobial drugs in the region and dynamic monitoring of MRSA in the future. Methods 86 clinical isolated MRSA strains were collected from three Grade III Class A hospitals in Chengdu during 2013-2014. After strain identification and susceptibility testing, clinical distribution and drug resistance surveillance were unfolded. Results 86 MRSA strains mainly came from respiratory tract（60.5 %） ,and were mainly from intensive care unit and respiratory department. There was significant statistical difference in the drug resistance rates of many antimicrobial drugs between MRSA and MSSA of random sampling（P〈 0.01）. Multiple drug-resistant MRSA strains accounted for 87.2% ,and there were 22 kinds of joint resistance patterns. The drug resistance rates of MRSA to most antibiotics in ICU were almost higher than those in non- ICU departments. MRSA strains showed different degree resistance to most antimicrobial drugs, and the differences in vitro antibacterial activity were large. MRSA strains to which MIC of vancomycin was 2mg/L accounted for 7.0%. Conclusion The elderly Pneumonia patients of over 65 years old should be accepted active screening of MRSA strains as early as possible, in order to be diagnosed and treated in the early stage. The vast majority of MRSA strains have multiple drug-resistance at the present stage in Chengdu,and MRSA strains have serious resistance to most antibiotics. Drug-resistant surveillance and control of MRSA strains should be strengthened in intensive care unit. MIC of vancomycin should be monitored dynamicly in Chengdu.
出处
《西部医学》
2015年第4期607-610,613,共5页
Medical Journal of West China
基金
四川省卫生厅科研课题(130382)
关键词
成都
耐甲氧西林金黄色葡萄球菌
临床分布
耐药性
Chengdu
Methicillin-resistant Staphylococcus aureus
Clinical distribution
Drug-resistance
