2013-2015年金黄色葡萄球菌的临床分布及耐药性分析

目的：分析徐州医科大学附属医院2013—2015年金黄色葡萄球菌的临床分布及耐药情况，为临床用药提供依据。方法：收集2013年1月1日至2015年12月31日各类标本检出的金黄色葡萄球菌，临床分离株药敏实验采用标准纸片扩散(K-B)法，结果采用WHONET5.6进行分析。结果：2013—2015年共检出金黄色葡萄球菌1725株，主要来源于痰液(35.4%)，在ICU(43.7%)和神经外科(12.6%)检出率最高。2013—2015年，耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus， MRSA)检出率分别为63.3%，59.8%，57.6%。MRSA耐药率大于50.0%的抗菌药物有庆大霉素(53.2%~73.1%)、妥布霉素(62.8%~64.9%)、环丙沙星(67.2%~75.3%)、红霉素(86.6%~92.9%)、四环素(53.5%~65.0%)；甲氧西林敏感金黄色葡萄球菌(methicillin-sensitive Staphylococcus aureus，MSSA)对抗生素的耐药率排在前3位的为青霉素(85.4%~93.3%)、红霉素(68.7%~72.4%)、复方新诺明(46.3%~57.9%)。结论：本院分离的金黄色葡萄球菌主要分布在ICU和神经外科，MRSA的耐药率普遍较高，临床医生应根据耐药性合理选用抗菌药物。

Clinical distribution and drug resistance ofStaphylococcus aureus from 2013 to 2015

Objective: To analyze the clinical distribution and drug resistance from 2013 to 2015 in Affliated Hospital of Xuzhou Medical University, so as to provide reasonable treatment for clinical antibiotic microbiota.Methods:TheStaphylococcus aureus(S. aureus) strains isolated from various specimens from Jan 1, 2013 to Dec 31, 2015 were collected, then the drug susceptibility testing of the clinical isolates was performed with Kirby-Bauer diffusion method. Data were analyzed by the WHONET5.6 sotfware.Results: A total of 1 725 strains ofS. aureus were isolated from 2013 to 2015. TheS. aureus strains were mainly isolated from sputum specimens (35.4%), and the positive-specimens were mostly derived from ICU (43.7%) and neurosurgery (12.6%). From 2013 to 2015, the constituent ratio ofmethicillin-resistant Staphylococcus aureus (MRSA) was 63.3%, 59.8% and 57.6%, respectively. The drug resistance rate of MRSA for many antibiotics greater than 50.0% included gentamicin (53.2%—73.1%), tobramycin (62.8%—64.9%), ciprofloxacin (67.2%—75.3%), erythromycin (86.6%—92.9%) and tetracycline (53.5%~65.0%). And, interestingly, the top 3 of the drug resistance ofmethicillin-sensitive Staphylococcus aureus (MSSA) were penicillin (85.4%—93.3%), erythromycin (68.7%—72.4%) and sulfamethoxazole-trimethoprim (46.3%—57.9%).Conclusion: hTe isolatedS. aureus distributes mainly in ICU and the department of neurosurgery. What’s more, the MRSA strains are highly resistant commonly. Doctors should choose the suitable antibiotics according to the fact of drug resistance.