耐甲氧西林金黄色葡萄球菌耐药性分析

目的了解耐甲氧西林金黄色葡萄球菌的耐药情况,为临床合理用药提供参考。方法收集2005年1月至2007年12月临床分离的460株金黄色葡萄球菌,经培养鉴定,采用纸片扩散法(K-B法)测定10种非β-内酰胺类抗菌药物的耐药情况。结果460株金黄色葡萄球菌中,检出耐甲氧西林金黄色葡萄球菌(MRSA)242株,占52.61%,甲氧西林敏感金黄色葡萄球菌(MSSA)218株,占47.39%;2005~2007年MRSA对复方磺胺的耐药率相对稳定在71.4%~77.5%之间,对红霉素、克林霉素、庆大霉素、左旋氧氟沙星、四环素和利福平的耐药率基本处于上升状态。MRSA对红霉素、克林霉素、庆大霉素、左旋氧氟沙星、四环素和利福平的耐药率明显高于MSSA相应的耐药率(P<0.001)。MRSA对呋喃妥因耐药率明显高于MSSA(P<0.001),对复方磺胺敏感率耐药率二者差异无统计学意义(P>0.05)。药敏结果显示,MRSA和MSSA菌株均对万古霉素和替考拉宁敏感。结论MRSA具有多重耐药特征,万古霉素和替考拉宁可作为治疗MRSA感染的首选药物,呋喃妥因和复方磺胺可作为次选药物。

Drug resistance analysis of methicillin resistant S.aureus

Objective To investigate the drug resistance of the meticillin-resistant S.aureus（MRSA） and to provide the reference for clinical reasonable use of drugs.Methods Four hundred and sixty S.aureus strains during the year of 2005^-2007 were collected,cultured and identified.The resistance to ten kinds of antimicrobial agents were detected by Disc agar diffusion method and the results were analyzed by WHONET 5.3 software.Results There were 242 MRSA strains（52.61%） and 218 methicillin sensitive staphylococcus aureus（MSSA） strains（47.39%）.The resistant rate of MRSA strains to sulfamethoxazole was relatively stable in 71.4%-77.5%.The resistant rates of MRSA strains to erythromycin,clindamycin,gentamicin,levofloxacin,tetracycline and rifampicin were much more higher than those of MSSA strains（P〈0.001）.The resistant rate of MRSA strains to furadantin was higher than that of MSSA（P〈0.001）,but there was no difference to sulfamethoxazole（P〉0.05）.MRSA and MSSA strains all had sensitivity to vancomycin and teicoplanin.Conclusion MRSA has the characteristic of multidrug resistance.Vancomycin is the first drug for infection of MRSA,while nitrofurantoin and sulfamethoxazole may be the second choice.