下呼吸道葡萄球菌感染的耐药性分析和治疗对策

目的通过对2005年1月～2007年12月期间，临床下呼吸道标本分离到的260株葡萄球菌进行耐药性分析，以了解葡萄球菌的耐药情况，指导临床合理使用抗生素。方法采用普通细菌培养及药物敏感测定。结果260株葡萄球菌中金黄色葡萄球菌、表皮葡萄球菌、溶血性葡萄球菌、和耳葡萄球菌占绝大多数（84．6％）；260株葡萄球菌对苯唑西林耐药238株占91．5％；金黄色葡萄球菌产β-内酰胺酶高达91％，明显高于其他葡萄球菌；所有葡萄球菌对万古霉素100％敏感。结论葡萄球菌检出率、MRS发生率和耐药率较高，应重视对MRS耐药性检测。治疗MRS引起的严重呼吸道感染应首选万古霉素，合理应用抗生素是延缓细菌耐药的关键。

Study on antimicrobial resistance and therapeutic strategy On staphylococcus infection in lungs

Aim To survey the resistance of Staphylococcus, and to provide the reference for the clinical antimicrobial agents usage. Methods The identification and drug susceptibility tests were carried out as normal. Results Most of 260 strains of staphylococcus were S aureus, S epidermidis, S haemolyticus and S auricularis, which were accounted for 84.6%. 238 strains of staphylococcus were ox- acillin resistant with the detecting rate of 91.5%. S aureus which introduced ESBL arrive to 91% ,higher than other staphylococcus. All staphylococcus were susceptible to vancomycin. Conclusions The incidences of Staphylococcus and MRS isolates and the resistance rates are relatively high. Much attention should been paid to detecting MRS, the resistance of MRS to antibiotics should be further monitored. Vancomycin may be used for the treatment of MRS infection first,