痰标本中金黄色葡萄球菌的耐药性监测

摘要

Objective A retrospective analysis was conducted to review the distribution and antibiotic resistance in the Staphy-lococcus aureus strains isolated from sputum and provide evidence for effective prevention and control of infections.Methods The 276 strains of S .aureus isolated during the period from January to September of 2009 were included in this analysis.The isolates were identified and tested for susceptibility using VITEK 2 Compact Automatic Culture and Identification System. Results The prevalence of methicillin-resistant S .aureus (MRSA)was 79.0% (218/276).The S .aureus strains were mainly isolated from Department of Neurology (27.5%,76/276),ICU (25.4%,70/276),Neurosurgery (18.1 %,50/276),and Re-spiratory Medicine (9.1 %,25/276).Vancomycin,teicoplanin and quinupristin-dalfopristin were the most active agents against these S .aureus .The resistant strains were less than 0.5%.MRSA showed lower resistance rate to trimethoprim-sulfamethox-azole than MSSA.MRSA strains were more resistant than MSSA to most other antibacterial agents.Conclusions The MRSA i-solates from sputum are highly prevalent and resistant to antibiotics.Antimicrobial agents should be selected appropriately ac-cording to the results of susceptibility testing.%目的：回顾性分析痰标本中金葡菌的临床分布和耐药情况，为制订预防控制措施提供依据。方法对2009年1月至2012年9月临床分离的276株金葡菌进行分析，细菌鉴定采用 VITEK 2 Compact 全自动细菌培养鉴定仪，药敏试验结果按CLSI 标准判断。结果耐甲氧西林金葡菌（MRSA）的检出率为79．0％（218/276）；临床分离的金葡菌主要分布为神经内科76株（27．5％）、ICU 70株（25．4％）、神经外科50株（18．1％）、呼吸内科25株（9．1％）。金葡菌对万古霉素、替考拉宁和奎奴普丁-达福普汀的耐药率均＜0．5％；MRSA 对甲氧苄啶-磺胺甲口恶唑的耐药率低于甲氧西林敏感金葡菌（MSSA）；MRSA 对其他大多数抗菌药物的耐药率高于 MSSA。结论 MRSA 的检出率和耐药率较高，临床应依据药敏试验结果合理选择抗菌药物。