耐甲氧西林葡萄球菌耐药性观察

目的研究葡萄球菌的感染及耐药性状况，指导临床用药。方法ＡＰＩ－Ｓｔａｐｈ鉴定分离菌株，药敏试验应用Ｋ－Ｂ法、最低抑菌浓度（ＭＩＣ）法、琼脂筛选法及ｍｅｃＡ基因聚合酶链反应（ＰＣＲ）检测耐甲氧西林葡萄球菌（ＭＲＳ）；并分别测定了ＭＲＳ、甲氧西林敏感葡萄球菌（ＭＳＳ）对青霉素等１３种抗生素的耐药率（Ｋ－Ｂ法）；分析了病人住院时间、抗生素使用与ＭＲＳ分离率间的关系。结果３０１株葡萄球菌中，耐甲氧西林金黄色葡萄球菌（ＭＲＳＡ）占４４．０％（３７／８４）（筛选法），耐甲氧西林凝固酶阴性葡萄球菌占６１．８％（１３４／２１７）（筛选法），ｍｅｃＡ基因ＰＣＲ法、琼脂筛选法检测ＭＲＳ阳性率较高；ＭＲＳ对青霉素等１３种抗生素的耐药率均高于ＭＳＳ；病人住院天数、抗生素使用与ＭＲＳ的分离率呈正相关。结论ＭＲＳ感染较为严重，需加强其对抗生素包括万古霉素的耐药性监测；注意ＭＲＳ检测方法存在的问题。

Infections of Staphylococci and their resistance to antibiotics

Objective To study infections caused by Staphylococci in our hospital and their resistance to antibiotics. Methods All isolates were identified by API and their resistance to oxacillin was tested by disk diffusion, agar dilution MIC, salt agar screen of NCCLS methods and mecAPCR. Susceptibility of MRS (methicillin resistant Staphylococcus) and MSS (methicillin sensitive Staphylococcus) to 13 kinds of antibiotics were tested by disk diffusion (K B) method. Analyzed the characters of patient, from whom MRS isolated. Results There were 301 isolates, the percentage of MRSA (methicillin resistant Staphylococcus aureus) and MRCNS (methicillin resistant coagulase negative Staphylococcus) were 44.0% (37/84) and 61.8%(134/217) respectively. The sensitivity of detecting MRS was higher in mecAPCR and agar screen methods. The more MRS was isolated in patients who hospitalized longer and treated using more antibiotics. Conclusions The infections of MRS were serious in our hospital. Their resistance to antibiotics should be monitored, ande antibiotics should be used rationalizedly. The methods to detect MRS should be used correctly.