2014年我院临床分离金黄色葡萄球菌的分布及耐药性分析

摘要

目的：了解我院2014年临床分离金黄色葡萄球菌的分布情况及耐药现状，为临床治疗相关感染提供依据。方法收集我院2014年全年临床各科室送检标本，采用法国BioMerieux VITEK2 Compact全自动细菌鉴定及药敏分析系统对菌株进行细菌鉴定和药物敏感性检测，并用Excel软件进行数据分析。结果2014年我院各种标本分离金黄色葡萄球菌共712株，标本分布主要以痰液(60.8%)为主，其次是脓液(17.8%)和分泌物(10.4%)；临床科室分布依次是儿科、呼吸內科和神经外科，分别占12.6%、10.8%和10.4%；MRSA菌株检出率为33.0%(235株/712株)，诱导克林霉素耐药菌株检出率为16.9%(120株/712株)。712株菌株对万古霉素，替加环素、奎奴普汀/达福普汀、利奈唑胺的耐药率最低，均为0%，对红霉素、克林霉素和四环素耐药率较高，分别是49.7%、48.0%和40.7%；MRSA菌株对红霉素、克林霉素、四环素、左氧氟沙星、环丙沙星、庆大霉素、莫西沙星和利福平的耐药率均比MSSA菌株高，且两者比较具有显著性差异(P<0.005)。结论我院临床分离金黄色葡萄球菌对红霉素、克林霉素和四环素的耐药性相对比较高，在临床经验用药方面应谨慎使用；另外MRSA菌株对抗菌药物的耐药性比较高，且呈多重耐药性，应加强监测控制，防止其流行传播。%Objective To investigate the distribution and drug resistance of clinical strains of Staphylococcus aureus in our hospital in 2014 and provide the laboratory evidence for guiding antibiotic therapy. Methods Collecting specimens from clinical departments in our hospital from Jan 2014 to Dec 2014, bacterial identification and antibiotic susceptibility tests were performed by BioMerieux VITEK2 Compact, and the data were analyzed with Excel 2003. Results A total of 712 clinical strains of Staphylococcus aureus were isolated, Most of them were isolated from sputum(60.8%), pus (17.8%) and secretions(10.4%), those isolates were mainly isolated from paediatric department (12.6%), respiratory medicine (10.8%),neurosurgery department (10.4%). The detection rates of MRSA and inducible clindamycin resistance were 33.0%and 16.9%, respectively. The drug resistance rates of erythromycin (49.7%), clindamycin (48.0%) and tetracycline (40.7%) were higher than those of other antibiotics;those strains were sensitive to vancomycin, tigecycline, Quinupristin / Dafoe leptin and Linezolid. The drug resistance rates of MRSA against erythromycin, clindamycin, tetracycline, levofloxacin, ciprofloxacin gentamicin, moxifloxacin and rifampicin were significantly higher than those of MSSA (P<0.005). Conclusion Clinical isolates of Staphylococcus aureus in our hospital have relatively high drug resistance rates to erythromycin, clindamycin and tetracycline, MRSA strains were highly resistant to antimicrobial agents, and showed multiple drug resistance. Therefore, it is necessary to intensify the surveillance to prevent the prevalence and spread of MRSA.