金黄色葡萄球菌的临床分布及耐药分析

目的分析医院金黄色葡萄球菌(SAU)的临床标本分布及耐药现状,为临床合理选用抗菌药物提供依据。方法收集2009年1月～2011年12月临床标本中分离的金黄色葡萄球菌,采用VITEK2-compact型全自动细菌分析仪进行鉴定和药敏试验及耐甲氧四林金黄色葡萄球菌(MRSA)的筛查。结果①共分离金黄色葡萄球菌1556株,标本类型主要为痰、伤口、脓液和血液,分别占50.0%、19.9%、7.6%和6.7%;②引流液是MRSA检出率最高的标本类型;检出的MRSA对大环内酯类、氨基糖苷类、喹诺酮类抗菌药呈多重耐药,其耐药率均>90.0%。未发现耐万古霉素和利奈唑胺的金黄色葡萄球菌;③不同科室分离出的金黄色葡萄球菌其耐药率不同:新生儿科及儿科分离的菌株对苯唑西林、利福平、庆大霉素和复方磺胺甲唑的耐药率明显低于其它科室;ICU分离的菌株对各种抗菌药物的耐药率明显高于其它各科。结论临床分离出SAU的标本类型主要为痰液、伤口分泌物、脓液和血液,引流液标本MRSA的检出率最高,其次为痰液。不同病区分离SAU耐药率不同,新生儿及儿科患者分离的金黄色葡萄球菌的耐药率最低,但红霉素的耐药率儿科最高,而急诊科及ICU分离的金黄色葡萄球菌耐药率最高。

Clinical distribution and antibiotic resistance analysis of staphylococcus aureus

Objective To investigate the current status about the drug resistance of staphylococcus aureus in hospital.Methods The staphylococcus aureus strains isolated from clinics were collected.Identification of MRSA and drug susceptibility test were performed by VITEK2-compact automatic analysis system.Results Sputum,pus,blood,and secretions samples were the main source of SAU.The highest detection rate of MRSA was from sputum.Continuous monitoring showed that MRSA were multi-drug resistant to macrolides,aminoglycosides and quinolones,and the resistance rates were all above 90.0%.No vancomycin-resistant strains and Linezolid-resistant strains were detected in 1556 strains of S.aureus.Resistance rates of SAU strains in ICU were higher than other Inpatient Areas;and resistance rates of SAU strains in neonatal unit were the lowest in our hospital.Conclusion The resistance rates to antibiotics from neonatal unit and pediatrics were significantly lower than those from other departments.Conclusions Sputum,pus,blood,and secretions samples were the main source of SAU.The highest detection rate of MRSA was from sputum.The lowest antimicrobial resistance rate of aureus to common antimicrobials was in neonatal unit and pediatrics and the highest was in ICU