2012年我院金黄色葡萄球菌耐药性分析及4年间耐药变迁分析

摘要

Objective To analyze the drug resistance in 176 strains of Staphylococcus aureus isolated from clinic in 2012 and the antibiotic resistance changes of Staphylococcus aureus in the last four years from The First Affiliated Hospital of Guangdong College of Pharmacy.Methods The pathogenic bacteria were evaluated by PHoenixTM100.Drug susceptibility test was carried out by MIC way.The results of all strains of Staphylococcus aureus during 2009 to 2012 were analysed by WHONET 5.4.Results 49.4％ of the 176 strains of Staphylococcus aureus in 2012 were distributed mainly in the sputum and ICU had the highest detection rate with 26.7％.100 s trains of methicillin-resistant Staphylococcus aureus (MRSA) were detected which accounted for 56.8％.All strains were sensitive to vancomycin,linezolid and teicoplanin,and the resistance rate to other antibiotics of MRSA was higher than meticillin-sensitive Staphylococcus aureus (MSSA)(P ＜ 0.05).There was 5.1％ detected rate of MRSA by oxacillin way less than that by cefoxitin way.All strains were sensitive to vancomycin,linezolid and teicoplanin in the last four years.The vancomycin geometric mean MICsof MRSA were 1.080、1.024、1.037、1.133 μg/ml,ang they were 0.804、0.840、0.818、0.938 μg/ml of MSSA.There was a significant difference between MRSA strains and MSSA strains (P ＜0.01).MIC trends were not found (P ＞ 0.05).Conclusion Resistance of Staphylococcus aureus is quite serious,and MRSA has multi-drug-resistance.Vancomycin,linezolid and teicoplanin are still very sensitive.MIC trends of vancomycin were not found.%目的 分析广东药学院附属第一医院2012年临床标本分离的176株金黄色葡萄球菌的耐药性情况及4年间该院金黄色葡萄球菌耐药变迁情况.方法 应用PHoenixTM 100全自动细菌鉴定分析仪对菌株进行药物敏感性试验,全部药物敏感试验采用MIC法鉴定；使用WHONET 5.4软件对2009至2012年间金黄色葡萄球菌药物敏感结果进行数据分析.结果 2012年该院分离出的176株金黄葡萄球菌的标本中以痰标本为主,占49.4％,检出率较高的科室是ICU,占26.7％；检出耐甲氧西林金黄色葡萄球菌(MRSA) 100株,占56.8％,除万古霉素、利奈唑胺、替考拉宁敏感率达100％外,MRSA对其他抗菌药物的耐药率高于对甲氧西林敏感金黄色葡萄球菌(MSSA) (P＜0.05)；苯唑西林MIC法较头孢西丁MIC法判断MRSA的漏检率为5.1％；4年中所有金黄色葡萄球菌对万古霉素、利奈唑胺、替考拉宁敏感率均为100％,万古霉素对MRSA的MIC 4年几何均值分别为1.080、1.024、1.037、1.133 μg/ml,对MSSA的MIC 4年几何均值分别为0.804、0.840、0.818、0.938 μg/ml,MRSA的MIC几何均值明显高于MSSA (P ＜0.01),无MIC值漂移现象(P＞0.05).结论 临床分离获得的金黄色葡萄球菌耐药情况较严重,尤其是MRSA表现为多重耐药,万古霉素、利奈唑胺、替考拉宁对金黄色葡萄球菌仍具有良好的抗菌活性,万古霉素对MRSA的MIC值4年间无漂移现象.