我院2004-2011年金黄色葡萄球菌对甲氧西林耐药性的动态变化特征分析

目的：了解我院金黄色葡萄球菌（SAU）的临床分布及耐甲氧西林金黄色葡萄球菌（MRSA）的耐药特征。方法：采用药敏纸片法和WHONET5.0软件对我院2004-2011年从临床分离的1608株SAU的分布及耐药情况进行回顾性分析。结果：SAU的主要来源为痰（占61.2%）,其次为伤口分泌物（占11.8%）、脓液（占8.1%）和血液（占7.9%）;SAU感染发生率较高的科室是重症监护室（占18.2%）、呼吸科（占17.4%）和神经科（占17.1%）;MRSA对氨基糖苷类、大环内酯类、林可酰胺类、氟喹诺酮类的耐药率与甲氧西林敏感金黄色葡萄球菌（MSSA）对上述药的耐药率比较,差异有极显著统计学意义（P〈0.01）。结论：我院MRSA对常用抗菌药物耐药性较强,多重耐药现象严重,对MRSA仍保持较强抗菌活性且耐药率小于30%的抗菌药物有利奈唑胺、替考拉宁、万古霉素、奎奴普丁/达福普汀、复方磺胺甲唑和呋喃妥因。合理使用抗菌药物、加强感染控制及寻找新的治疗手段对减缓耐药细菌的增长十分重要。

Characteristics Analysis of Dynamic Changes of Drug Resistance of Staphylococcus aureus to Methicillin in Our Hospital during 2004-2011

OBJECTIVE： To investigate clinical distribution of Staphylococcus aureus （SAU） and drug resistance of methicillin-resistant Staphylococcus aureus （MRSA） in our hospital. METHODS： The distribution and drug resistance of 1 608 clinical isolates of SAU in our hospital during 2004-2011 were analyzed retrospectively by disk diffusion method and WHONET 5.0 software. RESULTS： Of 1 608 strains, sputum samples accounted for 61.2%, followed by wound secretion （11.8%）, pus （8.1%） and blood （7.9%）; higher detection rate of SAU was from ICU （accounting for 18.2%）, respiratory department （accounting for 17.4%） and neurology department （accounting for 17.1%）; the resistance rate to aminoglycosides, macrolides, lincosamides and fluoroquinolones of MRSA were higher than that of MSSA, there was outstanding statistical difference （P0.01）. CONCLUSION： MRSA have stronger resistance to commonly used antibiotics and its multi-drug resistance is severe in our hospital. Among the antibiotics, linezolid, teicoplanin, vancomycin, quinupristin/dalfopristin synercid, compound sulfamethoxazole and nitrofurantion keep high antibiotic activity and have resistance rates less than 30%. It is importance for slowing down drug resistance bacterial growth to use antibiotics rationally, strengthen infection control and look forward new treatment methods.