ICU耐甲氧西林的金黄色葡萄球菌的分离及药敏分析

目的:探讨重症监护室(ICU)金黄色葡萄球菌(SA)的分离率及药敏情况,为有效预防控制感染提供科学依据。方法:常规方法分离金黄色葡萄球菌菌种,用法国生物梅里埃公司VITEK-2compat全自动微生物分析仪系统进行鉴定及药敏分析,并对耐甲氧西林的金黄色葡萄球菌(MRSA)及甲氧西林敏感的金黄色葡萄球菌(MSSA)药敏结果进行分析比较。结果:ICU 774株菌株中细菌分离率排在前7位的细菌分别是鲍曼不动杆菌占18.3%,白假丝酵母菌14.5%,铜绿假单胞菌占11.3%,金黄色葡萄球菌占11.1%,大肠埃希菌占6.2%,嗜麦芽窄食单胞菌占6.2%,肺炎克雷伯菌占6.1%,金黄色葡萄球菌排在第四位。86株金黄色葡萄球菌中MRSA47株占54.7%,MSSA39株占45.3%(89.5%分离于痰液)。药敏试验提示MRSA对抗菌药物呈多重耐药;除利福平、复方新诺明、万古霉素、呋喃妥因、奎诺普汀/达福普汀、利奈唑胺外,MRSA对其余9种抗菌药耐药率均高于MSSA,差异有统计学意义(P<0.05或P<0.01)。结论:ICU MRSA的分离率及耐药率均较高,MRSA表现为多重耐药性,应注意合理选用抗生素治疗并采取有效措施积极预防和控制好院内感染。

Distribution and Drug Resistance Status of Methicillin-resistant Staphylococcus Aueus from ICU

Objective: To discuss the distribution and drug resistance status of staphylococcus aueus,from intensive care unit(ICU),so as to provide the scientific basis for effective control of infection.Method:Conventional methods of isolated staphylococcus aueus(SA) bacteria,with the French company Biomerieux VITEK-2compat automatic bacterial system analyzer to identify and analyse drug susceptibility,and analysis of the resistance difference between MRSA and MSSA.Result: Among of the 774 strains of bacteria,the top 7 highest distribution was A.baumannii(18.3 0%),and then C.albicans(14.5%),P.aeruginosa(11.3%),S.aureus(11.1%),E.coli(6.2%),and P.mahophilia(6.2%),K.pneumoniae(6.1%),S.aureus in the fourth.Result: 87 SA strains isolated MRSA47,accounting for 54.7% of the total number of SA infecfions,MSSA49,accounting for 45.3%(separated out of sputum).Drug susceptibility test suggested that MRSA showed multiple drug resistance to antibacterial medicine;except rifampicin,cotrimoxazole,vancomycin,nitrofurantoin,quaynor tianeptine / dalfopristin,linezolid,the remaining 9 kinds of antimicrobial drug resistance rates of MRSA were higher than MSSA,the difference was statistically significant(P < 0.05 or P < 0.01).Conclusion: ICU MRSA distribution rate and drug resistance rate were higher,MRSA showed multiple drug resistance,we should pay attention to the rational use of antibiotics in the treatment and take effective measures to prevent and control hospital infection.