耐甲氧西林金黄色葡萄球菌的耐药性监测

目的 了解我院耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布和耐药情况,为预防控制措施的制定提供依据.方法 对2009年1月至2011年6月临床分离的294株金黄色葡萄球菌进行分析,细菌鉴定和药敏试验采用 VITEK 2 Compact 全自动细菌培养鉴定仪.结果 MRSA的分离率为66.0％(194/294),其主要病区来源为神经内科(56株,28.9％)、神经外科(41株,21.1％)、ICU病房(31株,16.0％)；标本来源主要为痰液(126株,64.9％).MRSA.甲氧西林敏感的金黄色葡萄球菌(MSSA)和β-内酰胺酶阳性金黄色葡葡球菌对万古霉素、替考拉宁、奎奴普丁/达福普汀和呋喃妥因的耐药率＜ 1.4％；MSSA对亚胺培南、氨苄西林/舒巴坦、利福平、左旋氧氟沙星和环丙沙星的耐药率＜7.1％,MRSA的耐药率均高达88.4％ ～97.6％；除万古霉素、替考拉宁、奎奴普丁/达福普汀、呋喃妥因和复方新诺明外,MRSA 对其他抗感染药物的耐药性高于MSSA,差异有统计学意义(P＜0.05).而MRSA对复方新诺明的耐药性反而低于MSSA.结论 MRSA 的检出率和耐药性较高,应及时监测、预防及控制.

Surveillance of antibiotic resistance of methicillin resistant staphylococcus aureus

Objective To provide theoretical basis for formulating measures of infection prevention and controlling by analyzing clinical distribution and drug resistance of Methicillin-resistant Staphylococcus aureus （ MR- SA） ,retrospectively. Methods All 294 MRSA strains were isolated clinically from January 2009 to June 2011, and VITEK 2 compact fully automated bacteria culture and identification analyzer was used to do bacteria identification and antibiotic susceptibility test. Results Total isolating rate of MRSA was 66.0% , and it was mainly isolated from departments of neurology（28.9% ,56/194） ,cerebral surgery （21. 1% ,41/194） and ICU（ 16.0% ,31/194）. The strains mainly isolated from sputum（64.9% , 126/194）. The drug resistance rates of MRSA, Methicillin Sensitive Staphylococcus Aureus （MSSA） and β-lactam positive staphylococcus aureus to vancomycin, Teicoplanin, quinupristin/dalfopristin and Nitrofurantoin were all lower than 1.4%. The resistance rates of MSSA to imipenem, ampicillinsulbactam, rifampicin, levofloxacin and ciprofloxacin were all lower than 7.1%, but those to MRSA were up to 88.4% -97.6%. Except vancomycin, teicoplanin, quinnpristin/dalfopristin and nitrofurantoin and sulfamethoxazole, the resistance of MRSA to the antibiotics tested were higher than that of MSSA（P 〈 0.05）. On the contrary, the resistance rate of MRSA to Sulfamethoxazole was lower than that of MSSA. Conclusion The detection rate and resistance rate of MRSA are comparatively high.