2000-2003年广州地区耐甲氧西林金黄色葡萄球菌耐药变迁及治疗对策

目的了解广州地区12家医院临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)的耐药现状及动态变化情况,为临床治疗提供对策。方法严格按NCCLS标准用K-B法对2000-2003年自广州地区12家医院临床分离出的1247株金黄色葡萄球菌进行微生物药物敏感性试验检测。结果1.2000-2003年每年的MRSA的检出率分别为50.8%(154/303)、65.0%(195/300)、61.1%(228/373)、70.8%(192/271),结果差异显著(P<0.001)。2.2000-2003年MRSA对受试的7种抗生素的敏感率分别为环丙沙星(C IP)22.1-40.0%、四环素(TET)35.1-50.3%、红霉素(ERY)12.0-18.9%、万古霉素(VAN)100.0%、克林霉素(CLI)45.8-68.2%、庆大霉素(GEN)20.2-40.1%、青霉素(PEN)0.0%,其中CLI、C IP、GEN的耐药性在四年间差异显著(P<0.001),而其他的几种抗生素均无差异(P>0.05),未发现耐万古霉素的MRSA。结论VAN是治疗MRSA感染的首选经验用药,为控制MRSA感染的发生,临床应合理使用抗生素。

Resistance Changes and treatment of Meticillin-Resistant Staphyococcus aureus in Guangzhou during 2000 -2003

Objective To study the resistance of Meticillin-Resistant Staphyococcus aureus(MRSA) from 12 hospitals in Guangzhou from 2000 to 2003 and give suggestion for clinical tretment.Method The suscepitibility test were detected by K-Bmethod according to the standards of NCCLS.Rusult The occupation rates of MRSA in every year from 2000 to 2003 were respectively 50.8%(154/303)?65.0%(195/300)?61.1%(228/373)?70.8%(192/271),the results existed significant difference(P<0.001);the suscepitibility rates of 7 antibiotics chosen were respectively Ciprofloxac(CIP)22.1-40.0%?Trtracycline(TET)35.1-50.3%?Eryrhromycin(ERY)12.0-18.9%?Vancomycin(VAN)100.0%?Clindanycin(CLI)45.8-68.2%?Gentamicin(GEN)20.2-40.1%?Penincillin(PEN)0.0%,the resistance to CLI,CIP and GEN existed significant difference(P<0.001),to others were no difference from 2000 to 2003,no MRSA was resistance to Vancomycin.Conclusion Vancomycin is the first drug for infection of MRSA,it's important to clinical workers to use antibiotics reasonable and to strengthen the control of infection of MRSA.