中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (1): 42-47.doi: 10.12007/j.issn.0258-4646.2018.01.010

• 论著 • 上一篇    下一篇

近10年我院金黄色葡萄球菌耐药性研究

廖凤慧, 王鹤, 刘学佳, 王齐晖, 田素飞, 褚云卓   

  1. 中国医科大学附属第一医院检验科, 沈阳 110001
  • 收稿日期:2017-07-11 出版日期:2018-01-30 发布日期:2017-12-23
  • 通讯作者: 褚云卓 E-mail:cyz6630@163.com
  • 作者简介:廖凤慧(1992-),女,硕士研究生.

Antimicrobial Resistance of Staphylococcus aureus in Our Hospital over the Last 10 Years

LIAO Fenghui, WANG He, LIU Xuejia, WANG Qihui, TIAN Sufei, CHU Yunzhuo   

  1. Department of Laboratory Medicine, The First Hospital, China Medical University, Shenyang 110001, China
  • Received:2017-07-11 Online:2018-01-30 Published:2017-12-23

摘要: 目的 回顾性分析近10年中国医科大学附属第一医院分离的金黄色葡萄球菌(SA)临床科室分布特点及其对抗菌药物的耐药性,为临床治疗选择合理抗菌药物提供依据。方法 收集2007至2016年我院临床分离的SA,采用法国生物梅里埃公司Vitek-2及美国BD Phoenix 100进行细菌鉴定和药敏试验。用WHONET 5.6软件对病原菌的分布及耐药情况进行统计分析。结果 2007至2016年共收集非重复SA 3 377株,其中耐甲氧西林金黄色葡萄球菌(MRSA)1 705株。SA占总标本的平均构成比为9.4%,MRSA占SA的平均构成比50.5%。SA主要分布为门诊和急诊776株,MRSA占16.8%;住院2 011株,MRSA占60.2%。SA主要标本来源为痰41.8%、脓17.9%、分泌物17.5%。MRSA对红霉素、左旋氧氟沙星、环丙沙星、四环素、庆大霉素平均耐药率高于75.0%;甲氧西林敏感金黄色葡萄球菌(MSSA)对红霉素的平均耐药率高达76.8%,对四环素、庆大霉素、环丙沙星、左旋氧氟沙星的平均耐药率低于25.0%。MRSA和MSSA对常见的11种抗生素的10年耐药率无明显变化。结论 我院MRSA的构成较高,尤其是来自非无菌部位的菌株,提示临床医生对于非无菌部位来源的MRSA,应注意感染与定植的鉴别,同时应做好医院感染控制工作,以降低MRSA的发生率。

关键词: 金黄色葡萄球菌, 耐药性, 耐甲氧西林金黄色葡萄球菌, 甲氧西林敏感金黄色葡萄球菌

Abstract: Objective To retrospectively analyze the clinical distribution and changes in antimicrobial resistance profiles of Staphylococcus aureus (S. aureus). Methods We collected clinical specimens of S. aureus from The First Hospital of China Medical University. The Vitek-2 and BD Phoenix 100 were performed for bacterial identification and drug sensitivity tests,and WHONET 5.6 was used to analyze the data. Results From 2007 to 2016,there were 3 377 unrepeatable strains of S. aureus,including 1 705 that were methicillin resistant S. aureus (MRSA). The isolation rate of S. aureus was 9.4% and of these,50.5% were MRSA. There were 776 S. aureus specimens from outpatients or the emergency department,including 16.8% MRSA,and 2 011 S. aureus from inpatient departments,including 60.2% MRSA. The main sources of specimens were sputum (41.8%),pus (17.9%),and body secretions (17.5%). The average resistance rates of MRSA for erythromycin,ofloxacin,ciprofloxacin,gentamycin,and tetracycline were higher than 75.0%. The average resistance rate of methicillin sensitive S. aureus (MSSA) for erythromycin was up to 76.8%,and for tetracycline,gentamycin,ciprofloxacin,and ofloxacin,were less than 25.0%. In 10 years,the average resistance rates of MRSA and MSSA for 11 kinds of common antibiotics had no obvious change. Conclusion The constituent rate of MRSA was high in The First Hospital of China Medical University,especially from the areas that were not sterile,suggesting that clinicians should pay attention to the identification of infection and sources for MRSA,which were from such areas. Hospital infection control should be focused on at the same time,in order to reduce the incidence of MRSA.

Key words: Staphylococcus aureus, drug resistance, methicillin resistant Staphylococcus aureus, methicillin sensitive Staphylococcus aureus

中图分类号: 

  • R378.1
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