耐甲氧西林葡萄球菌的耐药性监测及分析

目的监测葡萄球菌(包括MRS和MSS株)的耐药性,为临床合理选择抗生素提供依据. 方法药敏试验及耐甲氧西林葡萄球菌的检测均采用琼脂扩散法(K-B法),操作及结果判断均按NCCLS标准执行. 结果金黄色葡萄球菌与凝固酶阴性葡萄球菌的分离率分别占27.3%和72.7%;MRSA和MRSCON株的检出率分别为33.8%和78.6%;MRSA株对喹诺酮类的耐药性(22%～55%)明显低于MRSCON株(84%～90%);除万古霉素、呋喃妥因、阿米卡星和部分青霉素类外,MRSA和MRSCON株的耐药性显著高于MSSA和MSSCON株(P<0.05);未发现VRS株. 结论由MRS菌株引起的严重感染首选万古霉素治疗,发现MRS株实验室要根据NCCLS的有关规定修订药敏报告,并且及时切断传播途径,降低细菌的耐药性和医院感染.

Drug Resistance Supervision and Analysis of Meticillin-resistant Staphylococcus

OBJECTIVE To supervise the drug resistance of Staphylococcus (included MRS and MSS) and give foundation for clinic to choose antibiotic rationally. METHODS The MRSA and the drug sensitivity test in vitro were tested by K-B method, according the NCCLS standard to manipulate and judge the results. RESULTS The detectable rate of TBXS. aureus, coagulase-negative staphylococcus, MRSA and MRSCON was 27.3%, 72.7%, (33.8%,) and 78.6%, respectively. The drug resistance of MRSA to quinolones was lower than MRSCON except vancomycin, nitrofurantoin, amikacin and some penicillins. The drug resistance of MRSA and MRSCON was obviously higher than MSSA and MSSCON (P<0.05), VRS was not detected. CONCLUSIONS Vancomycin should be chosen firstly when the infection is clue to MRS and revise the drug sensitivity report according the relevant stipulation of NCCLS, then cut off the spread way and lower the drug resistance and hospital infection.