金黄色葡萄球菌感染现状分析

目的：了解金黄色葡萄球菌的临床分布情况及其对常用抗菌药物的耐药情况，指导临床合理选用抗菌药物提供依据，并分析MRSA感染的高危因素，预防其爆发流行，为临床防治提供依据。方法：对我院2009年1月-2013年1月期间临床各标本中分离的260株葡萄球菌进行鉴定，头孢西丁纸片扩散法进行MRSA检测，并用K—B法对常用的22种抗茵药物进行药敏鉴定。对MRSA暴露因素进行卡方检验，并对关联因素进行非条件logistic多元回归分析筛选出MRSA感染的高危因素。结果：金黄色葡萄球菌主要来源于痰液、浓汁、血液及其导管。感染部位主要集中于呼吸道、皮肤软组织、手术部位及其泌尿道等。科室主要分布于ICU科、神经外科、普外科、骨科及其烧伤科等。260株金黄色葡萄球菌中有184株为耐甲氧西林金黄色葡萄球菌（MRSA），其分离率为70．77％，MRSA对多种抗菌药物耐药率〉80．0％，甲氧西林敏感金黄色葡萄球菌（MSSA）76株，除对青霉素、红霉素、克林霉素外的大多数抗菌药物敏感。患者年龄、住院时间、基础疾病、使用抗生素、侵袭性操作、接受手术六个因素与MRSA感染有关联，并且基础疾病、使用抗生素、侵袭性操为其危险因素。结论：金黄色葡萄球菌感染严重，尤其是MRSA，呈现逐年升高趋势，并且其耐药率严重。基础疾病、使用抗生素、侵袭性操为其危险因素。

Infection present situation analysis of Staphylococcus aureus

Objective ： To investigate the clinical distribution of Staphylococcus aureus and its resistance to commonly used antibiotics, provide the basis to using of antimicrobial drugs for clinical,and analysis of risk factors for ismethicillin-resistant Staphylococcus aureus （MRSA） infection,prevent its outbreak ,provide the basis for clinical to prevention and treatment MRSA. Methods ： To identify the 260 separate aureus in our hospital from January 2009 - January 2013, using cefoxitin disk diffusion method to detect MRSA, using KB method to identified thesensitive of MRSA to the 22 commonly used antimicrobiat drugs, and usingnon-conditional logistic regression analysisto identify the risk factors for MRSA infection.Results ： Staphylococcus aureus was mainly from sputum, pus, blood and catheter. The site of infection is mainly concentrated in the respiratory tract, skin and soft tissue, surgical site and urinary tract. The department is mainly distributed in the ICU, neurosurgery, general surgery, orthopedics and its burns Branch.184 of 260 Staphylococcus aureus the separation rate is 70.77%.The antimicrobial resistance rate of MRSA mainly 〉 80.0%, 76 strains methicillin-sensitive Staphylococcus aureus aureus （MSSA）sensitiveto most antibacterial drugs but penicillin, erythromycin, clindamycin. The age of patients, duration of hospitalization, underlying disease, the using of antibiotics, the invasive operation, undergoing surgery are associated with MRSA infection.The risk factors are the underlying disease, the use of antibiotics and invasive operationare. Conclusions ： The infection of Staphylococcus aureus is serious, especially MRSA. They presents an increasing tendency and have a severe resistance rates. Underlying diseases, the use of antibiotics and invasive operation are their risk factors.