重症监护病房患者金黄色葡萄球菌感染及其耐药特征分析

目的了解重症监护病房患者金黄色葡萄球菌感染及其对16种抗生素的耐药性特征与变迁,为临床治疗提供依据。方法按NCCLS版纸片扩散法标准,测定并判读金黄色葡萄球菌对抗生素的耐药性,同时用纸片法测定耐甲氧西林金葡菌（MRSA）耐药表型。结果重症监护病房金黄色葡萄球菌以感染呼吸道为主,占74.4%。从2001~2006年,MRSA检出率已从61.3%上升至97.4%,β-内酰胺酶阳性率达100.0%,未发现耐万古霉素和替考拉林菌株,但对其他各类抗生素均呈高度耐药,对青霉素的耐药率连续3年为100.0%。结论重症监护病房金黄色葡萄球菌感染以MRSA为主,并对各类抗生素呈多重耐药,临床应重视耐药菌的检测与报告,合理使用抗生素及采取其他有效措施控制MRSA的感染。

Drug-resistance variation analysis of Staphylococcus aureus in the intensive care unit

Objective To investigate the resistance of Staphylococcus aureus to sixteen kinds of antimicrobial agents in the intensive care unit, and to provide basis for clinical therapy.Methods K-B disk diffusion method was used to determine the drug susceptibility of 266 strains of Staphylococcus aureus (SAU), and methicillin-resistance SAU was detected by using the disk diffusion method according to NCCLS.Results In ICU, SAU was isolated mostly from the respiratory tract, accounting for 74.4%. The isolated rate of MRSA increased from 61.3% in 2001 to 97.4% in 2006. The positive rate of beta lactamase was 100.0%. No SAU strains resistant to vancomycin and teicoplanin were found. SAU showed high drug resistance to other antibiotics, and the resistant rate of 100.0% to penicillin kept for continuous three years.Conclusion MRSA were the main infection of Staphylococcus aureus in the intensive care unit. Rational use of antibiotics should be carried out according to reporting of drug resistance, and measures should be taken to control the spread of MRSA infection.