四川省细菌耐药监测网2016—2020年耐甲氧西林金黄色葡萄球菌分布及耐药性分析

摘要：目的 统计分析2016—2020年四川省细菌耐药监测网成员单位耐甲氧西林金黄色葡萄球菌(MRSA)的分布及耐药情况,为抗菌药物的合理应用及细菌耐药变迁提供依据。方法 收集2016—2020年四川省92家成员单位医院门诊及住院患者临床标本中分离的去重金黄色葡萄球菌,按照CARSS的统一技术方案,并参照美国临床和实验室标准协会(CLSI)2019年标准,使用WHONET 5.6软件和SPSS 22.0软件进行数据统计分析。结果 检出的28366株MRSA以痰液(49.4%) 、脓液(39.2%)、血液(5.3%)、尿液 (1.4%)、咽拭子(1.4%)为主要来源。人群分布以成年人为主(43.9%),其次为儿童(27.6%)和老年人(22.9%)。庆大霉素、利福平、左氧氟沙星及复方磺胺甲恶唑呈逐年下降趋势;克林霉素、红霉素一直保持较高耐药水平;未发现对万古霉素、利奈唑胺、替考拉宁耐药的菌株。结论 我省MRSA的检出率及耐药率形势仍然严峻,临床应根据药敏结果合理使用抗菌药物,积极采取有效措施预防和控制感染。

Distribution and resistance analysis of methicillin-resistant Staphylococcus aureus of Sichuan provincial antimicrobial resistant investigation net from 2016 to 2020

Objective To statistically analyze the distribution and drug resistance of methicillin-resistantStaphylococcus aureus (MRSA) in the member units of the bacterial drug resistance monitoring network of sichuanprovince from 2016 to 2020, so as to provide evidence for the rational application of antimicrobial agents in sichuanprovince. Methods Deidentified Staphylococcus aureus isolated from clinical specimens of outpatients andinpatients in 92 member unit hospitals of Sichuan Province from 2016 to 2020 were collected following the uniformtechnical protocol of carss, and data were statistically analyzed using WHONET 5.6 software and SPSS 22.0 softwarewith reference to the American Society for Clinical and Laboratory Standards (CLSI) 2019 standards. Results Themain sources of 28366 strains of MRSA were sputum (49.4%), pus (39.2%), blood (5.3%), urine (1.4%) and throatswab (1.4%). The population distribution was dominated by adults (43.9%), followed by children (27.6%) and theelderly (22.9%). Gentamicin, rifampicin, levofloxacin and compound sulfamethoxazole decreased year by year.The resistance levels of clindamycin and erythromycin remained high. No resistant strains were found to linezolid,vancomycin or teicolanine. Conclusion The situation of detection rate and drug resistance rate of MRSA in ourprovince is still serious. We should use the drug rationally according to the result of drug sensitivity and take effectivemeasures to prevent and control the infection.