对294株临床分离金黄色葡萄球菌药敏试验结果分析

目的：调查分析安徽省铜陵市人民医院临床分离的金黄色葡萄球菌分布特征与药物敏感性试验结果,为临床合理用药提供参考。方法：对本院2005-2008年临床送检标本所分离的金黄色葡萄球菌病房分布与纸片法药敏试验结果进行分析。结果：294株金黄色葡萄球菌中,骨科（28.57%）、烧伤科（11.90%）、普外科（7.48%）等科室检出率较高,标本主要有创面分泌物（49.66%）、痰（29.59%）、脓液（8.50%）等,有明显的临床分布特征。其中耐甲氧西林金黄色葡萄球菌（MRSA）检出率为27.21%（80/294）,MRSA对大环内酯类、喹诺酮类、林可霉素类等药物呈多重耐药特征,而甲氧西林敏感金黄色葡萄球菌（MSSA）相对敏感。所有金黄色葡萄球菌对青霉素、氨苄西林、氨基糖苷类药物显示高耐药率;对磺胺甲唑-甲氧苄啶（复方新诺明）、呋喃妥因、利福平、磷霉素等抗菌药物的耐药率较低（〈20%）,未发现对替考拉宁、万古霉素耐药的菌株。结论：定期进行医院细菌流行病学调查和耐药性分析对临床合理用药具有指导作用。

Analysis of the results of drug susceptibility test of 294 strains of Staphylococcus aureus clinical isolates

Objective：To investigate and analyze the distribution of Staphylococcus aureus（SA） strains isolated from clinic and their susceptibility to antibiotics in the People’s Hospital of Tongling,in order to provide a reference for rational choice of antibiotics in clinic.Methods：The distribution of microbials and the results of susceptibility test by filter paper method of SA in the hospital during 2005 to 2008 were analyzed.Results：In the isolated 294 SA strains,clinical departments of orthopedics（28.59%）,burns（11.90%）,and general surgery（7.48%） had high detection rates,which showed apparent characteristics of clinical distribution.Submitted specimens were mainly wound secretions（49.66%）,sputum（29.59%）,pus（18.50%）,etc.The detection rate of methicillin-resistant Staphylococcus aureus（MRSA） was 27.21%（80/294）.MRSA showed characteristics of multi-drug resistance to macrolides,quinolones and lincomycin,while methicillin-sensitive Staphylococcus aureus（MSSA） was relatively susceptible to them.All SA strains showed high drug resistance rates to β-lactams,aminoglycosides,while they showed low drug resistance rates（less than 20%） to sulfamethoxazole-trimethoprim,nitrofurantoin,rifampicin and fosfomycin.No teicoplanin,vancomycin-resistant strains were found.Conclusion：Regular epidemiological investigation of bacteria in hospital and analysis of bacterial resistance can provide guidance for clinical rational drug use.