铜陵地区葡萄球菌耐药性检测

目的为了解铜陵地区葡萄球菌耐药性及社区获得性感染和医院获得性感染葡萄球菌耐药性特点,为葡萄球菌的流行病学及其感染的预防、控制和治疗提供可靠的依据。方法收集铜陵市人民医院2003年1月至2005年11月所有分离的葡萄球菌486株,经Vitek-32全自动微生物分析仪及鉴定卡鉴定,采用Kirby-Bauer纸片扩散法进行药敏试验。按美国国家临床实验室标准委员会(NCCLS)2002年版标准判定,医院感染诊断按卫生部《医院感染诊断标准》执行。结果486株葡萄球菌中,金黄色葡萄球菌161株,占33.1%,凝固酶阴性葡萄球菌325株,占66.9%。甲氧西林耐药金黄色葡萄球菌(MRSA)35株,占金黄色葡萄球菌21.7%。甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)274株,占凝固酶阴性葡萄球菌84.3%。486株葡萄球菌中429株来源于医院获得性感染,占88.3%,57株葡萄球菌来源于社区获得性感染,占11.7%。35株MRSA菌株中31株来源于医院获得性感染,占88.6%,274株MRCNS中有248株来源于医院获得性感染,占90.5%。57株社区获得性葡萄球菌中有30株为MRS,占52.6%。MRSA或MRCNS耐药性明显高于MSSA或MSCNS,对万古霉素和替考拉宁耐药率为0,对利福平耐药率为0～23.1%,对磷霉素耐药率为0～33.3%,对庆大霉素耐药率为80%左右,对环丙沙星耐药率为50%左右。结论葡萄球菌耐药形势严峻,MRS检出率高,尤其社区获得性MRS检出率增加,应引起临床医师高度重视。

An investigation on drug resistance of staphylococci in Tongling

Objective To investigate the drug resistance of staphylococcin in Tongling and the characteristics of drug-resistant staphylococci of community-acquired infection and hospital-acquired,to provide reliable basis for epidemiology of staphylococci and for the prevention,control and treatment of infection.Methods We collected 486 strains of separated staphylococci from Jan.2003 to Nov.2005 in Tongling People's.Hospital.They were tested by Vitek-32and Kirby-Bauer methods.According to NCCLS(2002),hospital infection diagnoses are carried out by“Hospital Infection Diagnosis standard”published by public health department.Results Of 486 strains of staphylococci,there were 161 strains of staphylococcus aurous,accounting for 33.1%;325 strains of coagulate negative staphylococci,66.9%.There were 35 strains of mythically-resistant staphylococci,accounting for 21.7% of SA.There were 274 strains of mythically-resistant coagulate negative staphylococci,accounting for 84.3% of CNS.Of 486 strains of staphylococci,429 strains came from hospital-acquired infection,accounting for 88.3%;57 stains came from community-acquired infection,accounting for 11.7%.Of 35 strains of MRSA,31 stains came from hospital-acquired infection,accounting for 88.6%.Of 274 strains of MRCNS,248 strains came from hospital-acquired infection,accounting for 90.5%.Of 57 strains of community-acquired staphylococci,30 stains were MRS,accounting for 52.6%.Drug resistance of MRSA or MRCNS was much higher than that of MSSA or MSCNS.The drug-resistant rate of MRSA or MRCNS to vancomycin and teicoplanin was 0%;to rifampicin,0-23.1%;to fosfomycin,0-33.3%;to gentamicin,about 80%;to ciproxacin,about 50%.Conclusions The situation of drug resistance of staphylococci is pressing.The detectable rate of MRS is high,especially that of community-acquirde MRS,which should be taken seriously by clinicians.