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。
Objective To retrospectively analyze the clinical distribution and changes in antimierobial resistance profiles of Staphylo- coccus 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 In analyze the data. Results From 2007 to 2016,there ,aere 3 377 unrepeatahle strains of S. aureus ,including 1 705 that were methieillin resistant S. aureus （ MRSA）. The isolation rate ofS. aureus was 9.4 % and of these,50.5 % were MRSA. There were 776 S. aureus spec- imens from outpatients or the emergency department, including 16.8 % MRSA, and 20l 1 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 resist- ance rates of MRSA for eEcthromycin, ofloxacin, eiprofloxacin, gentamycin, and tetracycline were higher than 75.0 %. The average resisl- ance 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 1 l 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.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2018年第1期42-47,共6页
Journal of China Medical University
