皮肤感染耐甲氧西林金黄色葡萄球菌的分布及耐药性分析

目的 了解医院门诊及住院患者皮肤感染耐甲氧西林金黄色葡萄球菌(MRSA)的检出率及其耐药性,并分析耐药菌株对皮肤感染患者抗菌治疗的影响.方法 对2009-2011年皮肤感染金黄色葡萄球菌的400例患者进行回顾性分析,用黑马微生物分析系统进行细菌鉴定和药敏试验.结果 2009-2011年MRSA分别检出52、61、88株,检出率为45.2％、50.4％、53.7％,MRSA对青霉素的耐药率为100.0％,对红霉素、庆大霉素、磺胺甲噁唑/甲氧苄啶、左氧氟沙星、克林霉素和四环素的耐药率均＞50.0％;耐药率在10.0％～50.0％的抗菌药物为哌拉西林/舒巴坦、阿米卡星、头孢唑林、头孢曲松、头孢哌酮,对替考拉宁耐药率非常低,仅2.0％；未出现耐万古霉素菌株.结论 皮肤感染金黄色葡萄球菌对常用抗菌药物呈多药耐药状态,及时进行病原菌培养和药物敏感试验,根据药敏结果采取措施,是控制感染的关键.

Distribution of methicillin-resistant Staphylococcus aureuscausing skin infections and drug resistance

OBJECTIVE To understand the detection rate and the drug resistance of MRSA causing skin infections in outpatients and the hospitalized patients and analyze the influence of the resistant strains on the antimicrobial treatment of the skin infections.METHODS A total of 400 patients with skin infections caused by Staphylococcus aureus were retrospectively analyzed,the dark horse microbial analytical system was employed for the identification of bacteria and drug susceptibility testing.RESULTS There were 52 strains(45.2%),61 strains(50.4%),and 88 strains(53.7%) of MRSA which were respectively isolated from 2009 to 2011,the drug resistance rate of MRSA to penicillin was 100.0%,the resistance rates to erythromycin,gentamicin,compound sulfamethoxazole,levofloxacin,clindamycin and tetracycline were higher than 50.0%,the drug resistance rates to piperacillin/sulbactam,amikacin,cefazolin,ceftriaxone,and cefoperazone varied from 10.0% to 50.0%,the drug resistance rate to teicoplanin was very low(2.0%);no vancomycin-resistant strains were found.CONCLUSION S.aureus causing skin infections is multidrug-resistant to common antibiotics;to perform the bacterial culture and the drug susceptibility testing in a timely manner and take measures in accordance with drug susceptibility testing is crucial for the control of infections.