摘要
目的了解金黄色葡萄球菌(以下简称金葡菌)的临床感染分布及其对抗菌药物的耐药性变化趋势,以指导临床合理用药。方法回顾性分析2007年1月至2010年12月临床各类送检标本中金葡菌的感染分布情况,并分别对甲氧西林敏感金葡菌(MSSA)和甲氧西林耐药金葡菌(MRSA)的耐药性进行分析。结果 999例金葡菌感染患者主要分布于老年病区和外科病房,标本来源以呼吸道分泌物和创面分泌物为主。金葡菌感染患者发生MRSA感染的有524例,检出率为52.5%;发生MSSA感染的病例为475例,检出率为47.5%。MRSA分离率连续4年分别为65.2%、57.8%、46.2%和43.9%,大致呈逐年下降趋势(P<0.05);MRSA对复方新诺明耐药率有上升趋势(P<0.05),对亚胺培南、庆大霉素、利福平、环丙沙星、克林霉素的耐药率呈下降趋势(P<0.05)。MSSA对常见的16种抗菌药物耐药率无显著性变化(P>0.05)。所有金葡菌感染患者中未分离到万古霉素耐药株。结论金葡菌感染患者多为老年患者和外科病房呼吸道感染及伤口感染,病情严重且呈多重耐药趋势;同时应加强对MRSA的主动筛查与综合管理,以防止该菌株在医院内暴发流行。
Objective To investigate the clinical infection and trend of resistance profile of Staphylococcus aureus（S, aureus） so as to provide base for clinical pharmacotherapy. Methods Distribution characteristics of infection of S. aureus in hospital from Janu ary 2007 to December 2010 were retrospective analyzed, and the resistance to frequently used antibiotics were performed in methicil linresistance S. aureus（MRSA） and methicillinresistant S. aureus（MSSA）. Results 999 cases with S. aureus infection is mainly distributed in the elderly wards and surgical wards, source of specimen with respiratory secretions and wound secretions. 524 cases of S. aureus infection in patients with MRSA, the detection rate was 52.5 % ;cases of MSSA infection occurred for 475 cases, the de tection rate was 47.5 % MRSA isolation rate for four consecutive years were 65.2 %, 57.8 %, 46.2 % and 43.9 % respectively, broadly declining trend（P〉0.05） ;The resistance rate of MRSA had upward trend to Sulfamethoxazole（P〈0.05） ,while the drug resistance rates against imipenem, gentamicin, rifampin, ciprofloxacin, clindamycin decreased Significantly over the 4 years （P〈 0.05）. Resistant to the 16 common antimicrobial agents in MSSA was no significant change （P〈 0. 05）. Vancomycinresistant strains were not detected in all of S. aureus infections in patients. Conclusion Patients with S. aureus infection are mainly isolated from respiratory tract and wound of older and surgery patients, infection and drug resistance is serious, and has multiple drug resist ance;simultaneously active screening and integrated management for MRSA should be strengthened to prevent the outbreak strains in hospitals.
出处
《国际检验医学杂志》
CAS
2012年第23期2879-2880,2882,共3页
International Journal of Laboratory Medicine
基金
广东省科技计划项目(20100309)
