1997～2001年耐甲氧西林葡萄球菌临床分离率及耐药性分析

目的　回顾分析耐甲氧西林葡萄球菌 (MRS)在临床的分离与耐药情况 ,了解本地区此类细菌的分离及耐药趋势。方法　统计分析 5年来医院内MRS的分离及耐药情况。结果　MRS从 1997年 5种 (5 1株 )增至2 0 0 1年 13种 (345株 )。 1997～ 2 0 0 1年 ,耐甲氧西林的金黄色葡萄球菌 (MRSA)与耐甲氧西林凝固酶阴性葡萄球菌 (MRS CN)对万古霉素耐药率为 0 ,对复方磺胺甲唑的耐药率分别为 6 .2 %～ 2 1.1%、2 2 .4 %～ 36 .4 % ;对其他种类抗生素耐药率均在 5 5 %以上 ;耐药率增长最快的为环丙沙星 :MRSA 5 1.4 %～ 88.6 % ;MRS CN5 6 .3%～ 88.8%。mecA基因检出率 :MRSA 98.8%～ 10 0 .0 % ;MRS CN 93.8%～ 99.0 %。结论　MRS在临床的分离率逐渐增加 ,其对非 β 内酰胺类抗生素的耐药率也在不断增加。临床在治疗葡萄球菌引起的感染时 ,准确判定感染菌是否为MRS对治疗方案的选定有重要意义     

耐甲氧西林葡萄球菌的临床检测及耐药性分析

采用药敏实验与MRS的检测均采用琼脂扩散法(K-B)法检测,测定耐甲氧西林金黄色葡萄糖菌(MRSA)及耐甲氧西林凝固酶阴性葡萄糖球菌(MRCNS)。结果 MRSA、MRCNS对头孢唑啉、苯唑西林、红霉素、氨苄西林的耐药率均为100%,明显高于其他抗菌药物,差异均有统计学意义(P<0.05),对复方新诺明耐药率分别为100%,93.26%,对哌拉西林、庆大霉素、左氧氟沙星、环丙沙星耐药率均>70%,对诺氟沙星耐药率分别为55.26%、89.72%,对呋喃妥因、氯霉素、利福平、阿米卡星耐药率均30%左右及以下,未检出对万古霉素、利奈唑胺、替考拉宁的耐药菌株。MRS具有多重耐药性,应积极进行病原学监测,为临床合理用药提供帮助,有效控制感染的发生。     

耐甲氧西林金黄色葡萄球菌的临床分布及耐药性分析

目的了解感染耐甲氧西林金黄色葡萄球菌（MRSA）的临床分布及对临床常用抗菌药物的耐药性。方法金黄色葡萄球菌（SA）采用ATB-Expression半自动细菌鉴定仪进行鉴定,采用头孢西丁纸片琼脂扩散法确定MRSA,药敏试验采用K—B纸片扩散法。结果185株SA中MRSA共计118株（63．78％）。MRSA病区分布以神经外科、肝胆烧伤外科、普外科和呼吸内科为主。118株MRSA对青霉素、氨苄西林、哌拉西林／他唑巴坦、头孢噻肟、美洛培南、环丙沙星、红霉素均耐药;对阿米卡星和利福平耐药率较高;没有发现耐万古霉素和替考拉宁的菌株。结论MRSA菌株表现为多重耐药性和高耐药性,万古霉素和替考拉林是有效控制MRSA感染的最佳抗茵药物。     

耐甲氧西林葡萄球菌耐药性观察

目的 研究葡萄球菌的感染及耐药性状况，指导临床用药。方法 ＡＰＩ－Ｓｔａｐｈ鉴定分离菌株，药敏试验应用Ｋ－Ｂ法、最低抑菌浓度（ＭＩＣ）法、琼脂筛选法及ｍｅｃＡ基因聚合酶链反应（ＰＣＲ）检测耐甲氧西林葡萄球菌（ＭＲＳ）；并分别了ＭＲＳ、甲氧西林敏感葡萄球菌（ＭＳＳ）对青霉素等１３种抗生素的耐药率（Ｋ－Ｂ法）；分析了病人住院时间、抗生素使用与ＭＲＳ分离率间的关系。结果 ３０１株葡萄球菌中，耐甲西林金黄     

耐甲氧西林葡萄球菌的临床分布特点及耐药性分析

目的探讨襄阳市中医医院耐甲氧西林金黄色葡萄球菌（MRSA）及耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的临床分布特点及其耐药性,为临床治疗葡萄球菌属感染提供正确选药依据。方法对2011年1～12月襄阳市中医医院各临床科室送检的各类标本中分离鉴定出的MRSA及MRCNS,采用琼脂纸片扩散（K-B）法进行药敏试验,对其药敏结果进行统计及分析,并探讨其临床分布与耐药特点。结果分离出的328株金黄色葡萄球菌中,MRSA有230株,占70.1%,以重症监护病房为最多,其检出率为85.5%,其次为骨伤科及内分泌科,检出率分别为83.6%及81.3%;210株凝固酶阴性葡萄球菌中,MRCNS有132株,占62.9%,以骨伤科最多,其检出率为74.6%,其次为呼吸内科和内分泌科,其检出率分别为73.9%和66.7%;MRSA和MRCNS均对氨基糖苷类、喹诺酮类、磺胺类等抗菌药物呈多药耐药性;尚未发现耐糖肽类和利萘唑胺的菌株。结论及时了解MRSA、MRCNS感染的分布与特征,监测其耐药情况,有助于临床及时采取合理的防治措施,有效控制感染及扩散。     

金黄色葡萄球菌耐药性分析及耐甲氧西林的检测

目的 了解我院金黄色葡萄球菌多重耐药性情况 方法 采用法国生物梅里埃ATB半自动细菌分析仪ID 32STAPH试条进行细菌鉴定,药物敏感试验采用K-B法。结果 共分离出116株金黄色葡萄球菌,其中MRSA 75株占金黄色葡萄球菌的64.5％,MRSA为多重耐药,对β-内酰胺类药物均耐药。结论 金黄色葡萄球菌的耐药问题相当严重,MRSA所占比例较高     

耐甲氧西林金黄色葡萄球菌临床感染监测及耐药性分析

目的研究分析不同年度耐甲氧西林金黄色葡萄球菌(MRSA)的临床感染情况及耐药性。方法收集2008年1月至2010年12月本院微生物室分离的金黄色葡萄球菌,采用Phoenix-100全自动细菌鉴定药敏系统进行药物敏感试验,经仪器判定苯唑西林耐药的菌株为MRSA。结果 3年共分离出金黄色葡萄球菌菌株1 048株,其中MRSA 793株,占金黄色葡萄球菌总数的75.7%,2008~2010年分别为63.3%、72.7%、81.5%。MRSA对多种药物耐药,但对万古霉素、利奈唑胺、甲氧苄氨嘧啶、奎奴普丁/达福普汀、替考拉宁、呋喃妥因有较好的敏感性,无万古霉素、利奈唑胺耐药菌株出现。结论近3年来北京航天总医院的MRSA的分离率逐步增高,应加强监测,并为临床合理使用抗菌药物提供必要的实验室依据,以利于医院MRSA感染的控制。     

耐甲氧西林金黄色葡萄球菌耐药性观察

随着介入治疗手段的广泛应用,以及免疫抑制剂,超广谱、广谱药物的大量使用等诸多因素,使金黄色葡萄球菌成为医院感染的主要病原菌之一,临床上尤其以耐甲氧西林的金黄色葡萄球菌（MRSA）为多见。MRSA除对甲氧西林耐药外,还对其他抗生素呈多重耐药,所以感染后治疗不仅难度大,而且病死率高,准确分离MRSA合理选用抗生素及控制其感染是一系列急需解决的问题,其中首要任务是对MRSA的严密监测,为此我们从临床各类标本中分离出金黄色葡萄球菌（SA）进行实验研究。1材料与方法1．1菌株来源60株SA全部来自山西医大二院1998年8月初一…     

肿瘤病人耐甲氧西林葡萄球菌的分布及耐药性分析

目的了解我院肿瘤病人葡萄球菌感染的分布及耐药情况,从而为病原学调查及临床选用抗生素提供依据。方法采用常规方法进行分离培养,鉴定及药敏试验均采用美国德灵公司的MicroScan细菌鉴定及药敏分析系统。结果本文共分离出57株葡萄球菌。耐甲氧西林葡萄球菌为40株,检出率为70.18%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率52.63%。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率17.54%。耐甲氧西林葡萄球菌对利奈唑烷、呋喃妥因、万古霉素均敏感,其余大部分抗生素呈高度耐药(50%～100%)。结论耐甲氧西林葡萄球菌有很高的耐药性且大多为多重耐药。临床要严格按照药敏结果谨慎使用抗生素。     

耐甲氧西林金黄色葡萄球菌的SCCmec分型及耐药性分析

目的探讨临床分离的346株耐甲氧西林金黄色葡萄球菌(MRSA)菌株的临床分布、SCCmec分型及其对常用抗菌药物的耐药情况。方法选择2014年1月至2015年1月该院分离的784例金黄色葡萄球菌(SA),采用PCR方法对其进行MRSA及MRSA SCCmec基因分型鉴定,并对其检出分布及耐药性进行分析。结果 784株SA中MRSA 346株(占44.13%),MRSA中来自痰液占43.06%,伤口分泌物占48.55%;MRSA对青霉素、左氧氟沙星、红霉素耐药性较高,对万古霉素、利奈唑胺、替考拉宁均敏感。MRSA经SCCmec分型,共发现SCCmecⅡ型130株,SCCmecⅢ型196株,SCCmecⅣ型11株,SCCmecV型9株。结论该院分离的MRSA以SCCmecⅢ型为主,MRSA对多种抗菌药物具有耐药作用,但对万古霉素、替考拉宁等敏感。     

Increasing prevalence of methicillin-resistant Staphylococcus aureus causing nosocomial infections at a university hospital in Taiwan from 1986 to 2001

A rapid emergence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection (from 26.3% in 1986 to 77% in 2001) was found. The susceptibility of 200 nonduplicate blood isolates of MRSA and 100 MRSA isolates causing refractory bacteremia to 22 antimicrobial agents disclosed that glycopeptides, quinupristin-dalfopristin, and linezolid remained the most active agents.     

2007-2009年神经外科耐甲氧西林的金黄色葡萄球菌耐药性分析

目的了解神经外科耐甲氧西林金黄色葡萄球菌（MRSA）的耐药性,为制定医院感染的预防和控制措施提供参考依据。方法对2007年1月-2009年12月神经外科住院的MRSA感染患者进行跟踪调查并对病原菌耐药情况进行分析。应用VITEK全自动微生物分析仪进行菌种鉴定和药敏试验,结果用WHONET 5.5软件进行统计分析,按美国临床实验室标准化研究所（CLSI）标准对常用抗菌药物进行耐药性分析。结果神经外科MRSA分离率逐年增加,共分离出493株MRSA,检出率为83.7%。药敏结果显示MRSA除了对万古霉素、替考拉宁、利奈唑胺及喹奴普丁、达福普丁抗菌药物较敏感外,对其它抗菌药物均具有较强的耐药性。结论神经外科是MRSA感染的高危部门,应加强神经外科患者MRSA的筛查,加强气管切开等侵入性操作患者的管理,严格环境和物品的消毒处理,避免MRSA的院内传播。     

Widespread quinolone resistance among methicillin-resistant Staphylococcus aureus isolates in a general hospital.

Ofloxacin and ciprofloxacin resistance (MIC, greater than 4 micrograms/ml) was encountered in 45 of 50 clinical isolates of methicillin-resistant Staphylococcus aureus. None of 20 methicillin-susceptible strains was resistant to the quinolones (P less than 10(-6). Quinolone-susceptible and -resistant isolates did not differ with respect to culture source or bacteriophage type. The future usefulness of quinolones for S. aureus infection may be limited.     

Impact of community-acquired methicillin-resistant Staphylococcus aureus in the hospital setting

The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is undergoing a transformation as isolates of this historically health care-associated pathogen are reported with increasing frequency in otherwise healthy community-dwelling individuals. This article provides a brief review of the differences between health care-associated and community-acquired MRSA and discusses the potential impact of the changing epidemiology of MRSA on the hospital setting.     

Expression of resistance to tetracyclines in strains of methicillin-resistant Staphylococcus aureus

A diverse collection of methicillin-resistant Staphylococcus aureus (MRSA) isolates resistant to tetracycline was screened by PCR for the presence of the resistance determinants tetK, tetL, tetM or tetO. Twenty-four of 66 isolates had tetM alone, 21 had tetK alone and 21 had both tetK and tetM (tetKM). All isolates were tetL- and tetO-negative. MICs of tetracycline, doxycycline and minocycline were evaluated for all isolates with or without preincubation in the presence of subinhibitory concentrations of tetracycline or minocycline. All isolates with one or more tetracycline resistance determinants were resistant to tetracycline 8 mg/L without induction of resistance. Some MRSA isolates of each of these three genotypes showed an unexpected lack of resistance to tetracyclines when the disc diffusion or agar dilution method was applied to uninduced cells. Resistance to tetracycline and doxycycline was greater (two- to four-fold) in tetK cells preincubated with tetracycline (tetK MRSA isolates were susceptible to minocycline 相似文献   

Ciprofloxacin resistance in methicillin-resistant Staphylococcus aureus: associated factors and resistance to other antibiotics

At the University of Illinois Hospital, antibiotic susceptibility testing was retrospectively performed on 254 stored clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates cultured from 1985 through 1990 to characterize resistance to ciprofloxacin and other antibiotics. In case-control analyses, inpatients with and without ciprofloxacin-resistant strains were compared. Ciprofloxacin-resistance increased from 7% before 1988 to 83% in 1990. A sudden increase in resistance to trimethoprim-sulfamethoxazole also occurred in 1988, and by 1990, 65% of strains were resistant to both antibiotics. In 95 patients with recent MRSA isolation (70 acquired nosocomially, 25 acquired in the community), ciprofloxacin resistance was more common in the nosocomial group (80% v 60%, P < 0.05). In that group, no host or in-hospital factors were associated with ciprofloxacin resistance. Among community cases, a greater proportion with ciprofloxacin-resistant MRSA had diabetes mellitus (60% v 0%, P = 0. 002). Thus, with use, ciprofloxacin resistance emerged rapidly in MRSA and developed particularly among strains resistant to trimethoprim-sulfamethoxazole. Combined resistance to these antibiotics, uncommon in previous reports, severely limits oral therapy as an option for MRSA carriage or infection.     

下呼吸道耐甲氧西林金黄色葡萄球菌的耐药性检测及分析

目的分析和总结该地区患者下呼吸道临床分离出的耐甲氧西林金黄色葡萄球菌(MRSA)的耐药性,为临床治疗和控制该类感染提供依据。方法对该院2008~2010年患者下呼吸道感染痰标本进行分离培养,将鉴定出的金黄色葡萄球菌进行MRSA的耐药性检测,并把MRSA药敏资料进行统计分析。结果 209株金黄色葡萄球菌中,MRSA的比例占83.25%,MRSA呈多重耐药性。结论下呼吸道感染标本的耐甲氧西林金黄色葡萄球菌分离率显著增高,耐药性日趋严重,应引起临床高度重视。     

Aminoglycosides resistance of methicillin-resistant Staphylococcus aureus]

In the last decade, there has been a dramatic increase in the isolation frequency of methicillin-resistant Staphylococcus aureus (MRSA) in Japan. Especially, a high incidence of multiple resistant MRSA strains has been reported. These strains are resistant not only to beta-lactams but to aminoglycosides and macrolides. About 90% of MRSA strains were resistant to gentamicin (GM) and/or tobramycin (TOB), producing an aminoglycoside modifying enzyme, mainly, APH (2")/AAC (6) and/or AAD (4',4"). Based on these modifying enzymes produced, MRSA strains were classified into three groups; group 1 produced APH (2")/AAC (6), belonging to phage group I and coagulase IV, group 2 produced AAD (4',4"), belonging to phage group III and coagulase II, and group 3 produced APH (2")/AAC (6) and AAD (4',4"), belonging to phage group III and coagulase II. The epidemiological results suggest that MRSA strains changed from group 1 to group 2, and then to group 3. Recently, arbekacin (ABK), a new anti-MRSA aminoglycoside, has been introduced into clinical practice. ABK shows a potent activity to GM-resistant strains, due to poorly modification by APH (2")/AAC (6'). However, there were few ABK- and GM-resistant strains in clinical isolates. These strains produced a higher amount of the enzyme than ABK-susceptible and GM-resistant strains. This observation suggests that ABK-resistant strains might be derived from GM-resistant strains by mutation of the gene coding APH (2")/AAC (6').