医院分离耐甲氧西林金黄色葡萄球菌的临床分布与耐药分析

目的：了解医院分离的耐甲氧西林金黄色葡萄球菌（MRSA）的分布情况及耐药性特点，为临床合理使用抗生素提供理论依据。方法对2013年1月-2013年12月间临床标本中分离的86株 MRSA，采用 WalkAway 96 PLUS 型全自动细菌分析仪进行鉴定和药敏试验，应用 WHONET5.6软件对结果进行统计和分析。结果从临床标本中分离出的285株金黄色葡萄球菌中检出 MRSA 86株，检出率为30.18%；主要分布于各重症监护室（40.70%）、儿科病房（20.9%）及各外科病房（15.12%）；标本的主要来源为痰液和创面分泌物，所占比例分别为43.02%和34.88%。MRSA 对万古霉素、利奈唑胺及达托霉素的耐药率为0，对红霉素、克林霉素及四环素耐药率分87.2%、77.9%和74.4，对环丙沙星、庆大霉素的耐药率均大于50%。结论本院检出的 MRSA 具有高耐药和多重耐药的特点。医院应重视多重耐药菌株的监测，药敏结果的检测工作，对于指导临床合理用药、减少耐药株的产生及传播具有重要意义。

Clinical distribution and drug-resistance of methicillin-resistant Staphylococcus aureus separated in hospital

ObJective：To investigate the distribution and drug-resistance of methicillin-resistant Staphylococcus aureus （MRSA）separated in clinal so as to provide the basis for clinics to select antibiotics reasonably. Methods：Eighty-six strains of MRSA were isolated from January 2013 to December 2013. The identification and antimicrobial susceptibility tes-ting of the strains was performed by WalkAway 96 PLUS automatic bacterial identification system,and the test results were analyzed by WHONET5. 6 analytics software. Results：A total of 285 strains of S. aureus were isolated from clinical speci-mens,there were 86 strains of MRSA（30. 18% ）,which mainly distributed in each ICU（40. 70% ）,pediatric Wards （20. 9% ）and various surgical wards（15. 12% ）;the sputum and wound secretions were the main specimens resources, accounting for 43. 02% and 34. 88% ,respectively. Drug-resistance of MRSA to vancomycin,linezolid and daptomycin were 0;to erythromycin,clindamycin and tetracycline were 87. 2% ,77. 9% and 74. 4;to ciprofloxacin,gentamicin resist-ance were all higher than 50% . Conclusion：MRSA detected in clinics have the characteristics of high resistance and multi-ple resistance. The hospital should pay attention to the monitoring of multiple drug-resistant strains and antimicrobial sus-ceptibility tests,which has profound significance for instructing application of the antibiotics reasonably and reducing the production and dissemination of resistant strains.