金黄色葡萄球菌的耐药分析

目的调查临床分离的金黄色葡萄球菌耐药现状，为临床合理使用抗生素提供依据。方法收集2007年1月-2009年5月无锡市第二人民医院连续分离的非重复金黄色葡萄球菌643株，用全自动微生物仪进行菌种鉴定和药敏实验，以K—B法测替考拉宁的药敏。结果耐甲氧西林金黄色葡萄球菌（MRSA）占分离总数的71．7％，所有菌株对替考拉宁、万古霉素、呋喃妥因和利奈唑胺均敏感。MRSA的耐药性显著高于甲氧西林敏感金黄色葡萄球菌（MSSA），MRSA对β-内酰胺类、红霉素、四环素、亚胺培南、克林霉素、庆大霉素、左氧氟沙星等抗菌药物的耐药率为82．6％～100％、92．7％、74．8％、92．O％、74．5％、90．5％、78．6％，说明MRSA多重耐药严重，对其他受试药的耐药率均〈10％。MSSA除对青霉素、克林霉素及红霉素耐药率高达93．0％、45．6％和45．6％，对其余抗菌药物的耐药率较低，为0～23％之间。结论MSSA对大部分抗菌药物保持较好的敏感性，MRSA较MSSA的耐药性高，MRSA多重耐药严重，必须加强金黄色葡萄球菌的监控，以最大限度降低其耐药性发生。

Antibiotics Resistance of Staphylococcus Aureus

Objective] To investigate the antibiotics resistance of clinical isolates of Staphylococcus aureus, and provide evidence for rational use of antibiotics. Methods] From January 2007 to May 2009, 643 consecutive and non-duplicate Staphylococcus aureus isolates were collected from Wttxi Second people＇s Hospital. The identification and susceptibility test of the isolate were determined by automated microbiology analyzer. K-B method was used for antibiotics resistance of teicoplanin. Results] The prevalence of methicillin-resistant Staphylococcus aureus （MRSA） was 71.7% of total isolates. All isolates were susceptible to Teicoplanin, Vancomycin, Nitrofurantion, and Linezolid. The antibiotics resistance of MRSA was significantly higher than that of Methicillin-sensitive Staphylococcus aureus（ MSSA）. The resistant rate of MRSA toβ-lactam antibiotics, erythromycin, tetracycline, imipenem, clindamycin, gentamicin, levofloxacin and other antibiotics was 82.6% - 100%, 92.7%, 74.8%, 92.0%, 74.5%, 90.5%, 78.6%, 〈 10%, respectively that indicated MRSA strains were serious multi-drug resistant. The resistant rate of MSSA to penicillin, clindamycin and erythromycin reached up to 93.0%, 45.6% and 45.6%, respectively; but to other antibiotics, the resistant rate was down to 0 - 23%. Conclusion]MSSA keeps fairly good sensibility to most antibacterial medicine . Compare to MSSA, MRSA has higher antibiotic resistant rate and more serious drug-resistance. Therefore, surveillance on Staphylococcus aureus should be strengthened to reduce the occurrence of its resistance maximally.