420株耐甲氧西林金黄色葡萄球菌（MRSA）的临床分布特点及耐药性分析

目的 探讨耐甲氧西林金黄色葡萄球菌（MRSA）菌株的临床分布特点及耐药趋势,为临床合理使用抗菌药物提供依据.方法 对我院2008年1月至2012年12月分离出的420株MRSA菌株进行标本来源、科室分布、患者年龄/性别及耐药性的统计分析,并进行年度间的比较.结果 420株MRSA主要分离自痰标本,占62.9％.MRSA的平均检出率为27.4％,科室分布主要以神经外科、呼吸内科、重症监护室（ICU）为主,MRSA培养阳性在50岁以上的患者中占较大的比例,约占总数的3/4,且男性MRSA检出率高于女性.MRSA对复方新诺明的耐药率基本低于10％,对利奈唑胺耐药率保持较低水平,对万古霉素敏感,对其他抗菌药物呈多重耐药.不同年份检出率比较显示,我院金黄色葡萄球菌耐药情况从2008-2009年下降后一直保持稳定.结论 金黄色葡萄球菌是医院感染的重要病原菌,临床分布广,耐药性强.加强医院感染控制工作,遵循抗菌药物使用原则,合理应用敏感抗菌药物,是控制MRSA感染及减缓MRSA对糖肽类抗生素耐药性发展的有效措施.

Clinical distribution and drug resistance characteristics of 420 strains methicillin-resistant staphylococcus aureus

Objective To investigate clinical distribution and drug resistance characteristics of methicillin-resistant staphylococcus aureus （MRSA） and provide theoretical basis for clinical application of antibiotics reasonably. Methods A retrospective analysis was performed for specimens source, distribution department, patient age＆gender and drug sensitivity of 420 strains of MRSA strains screened from staphylococcus aureus at our hospital from January 2008 to December 2012. Results The MRSA strains were mainly isolated from sputum specimens （ 62. 9% ）, mainly distributed in neurosurgery department, respiratory department and intensive care unit （ICU） ,50 to 80 years old patients accounted for larger proportion of MRSA culture positive patients, in addtion, those who were older than 50 years old accounted for about three-quarters of all. The amounts of male patients were significantly higher than those of women in each year. MRSA resistance rate to cotrimoxazole was less than 10% approximately and were multi-resistant to other antibiotics. Staphylococcus aureus resistant status was relatively stable after the decline from 2008 -2009 according to the comparison during the different years. Conclusion Staphylococcus aureus is an important pathogen of nosocomial infection, with wide clinical distribution and strong drug resistance. Timely submission and accurate detection of speci- mens ,the application of sensitive antibiotic drugs, such as cotrimoxazole, can effectively control the generation of MRSA.