葡萄球菌耐药性监测及其感染的治疗对策

目的研究葡萄球菌的临床分布和耐药性,指导临床合理应用抗生素.方法应用ATB自动细菌鉴定仪及药敏分析仪对临床标本中分离的327株葡萄球菌进行鉴定和药敏试验,同时进行(ORS检测,并结合临床资料进行分析.结果共分离出葡萄球菌327株,其中金黄色葡萄球菌138株(42.2%)居第一位;表皮葡萄球菌101株(3o.9%)位居第二;其他如溶血葡萄球菌、人葡萄球菌、沃氏葡萄球菌等均占有一定比例.327株葡萄球菌中共检出耐苯唑西林葡萄球菌(ORS)230株,占70.3%,苯唑西林敏感葡萄球菌(OSS)97株.OSS对青霉素和红霉素的耐药率高,分别为80.8%～82.2%和44.4%～51.9%,对其他抗生素均敏感.ORS对万古霉素、替考拉宁、呋喃妥因和利福平等敏感性高,对其余多种抗生素耐药.葡萄球菌主要分离自呼吸道、感染伤口、泌尿道和血液等标本.科室分布依次是ICU、肿瘤科和外科等.结论临床分离菌中的葡萄球菌日益增多,对抗生素的耐药率增高,应重视ORS的检测和药敏试验.同时临床医师应根据药敏结果合理有效地选用抗生素.

Antimicrobial resistance and therapeutic strategy for Staphylococcus infections

OBJECTIVE To survey the antimicrobial bacterial resistance of Staphylococcus to guide the rational use of antibiotics. METHODS Identification and drug susceptibility tests were analyzed by ATB automatic microbiology analytical instrument system, and meanwhile we detected oxacillin-resistant Staphylococcus (ORS), and analyzed the clinical data RESULTS We collected 327 strains of Staphylococcus in our hospital, of which 138 strains of Staphylococcus aureus (42. 2%) were the first place, 101 strains of Staphylococcus epidermidis (30. 9%) were in the second place, and others (such as S. haemolyticus, S. hominis, S. warneri, et al) were also detected. There were 230 ORS strains isolated and accounted for 70. 3% of the 327 isolates of Staphylococcus. Among the 97 OSS strains, the resistant rates of penicillin and erythromycin were 80. 8%-82. 2% and 44. 4%-51. 9% respectively, while most OSS strains were sensitive to the other 12 antibiotics. All ORS strains were sensitive to teicoplanin, vancomycin and most of them were sensitive to nitrofurantoin and rifampin. However most of these strains were resistant to other antibiotics. Staphylococci were mainly isolated from the respiratory tract, infected wounds, urinary tract, and blood, Most of them were from ICU, surgery and tumor department. CONCHUSIONS The number of Staphylococcus among clinical isolates as well as their antibiotic resistance is increasing. The incidence of ORS is high in our hospital. We should pay much attention to detecting ORS and their susceptibility to antibiotics ,and use the antibiotics more reasonably and effectively.