摘要
目的探讨苏州高新区人民医院耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布特点及其耐药性,为临床治疗葡萄球菌属感染提供正确选药依据。方法对2015年1月至2017年8月苏州高新区人民医院临床各科送检的各类标本中分离鉴定出的MRSA,采用MIC法进行药敏试验,并探讨其临床分布与耐药特点。结果分离出的170株金黄色葡萄球菌中,MRSA有40株,占23.5%,以呼吸科病房为最多(20株),占50.0%、其次是重症监护病房(ICU)、儿科、神经内科;多重耐药的MRSA对所有β-内酰胺类高度耐药,对大环内酯类耐药率为67.5%;对克林霉素类耐药性较高,其中红霉素诱导的克林霉素耐药率为47.5%,提示该药在苏州地区已不能够用于MRSA感染的治疗。对氨基糖苷类、氟喹诺酮类耐药率较低(耐药率<30%),磺胺甲噁唑、甲氧苄啶及利福平具有良好的活性,尚未发现耐糖肽类和利萘唑胺的菌株。结论苏州地区近3年来MRSA菌株检出率较低;对常用抗菌素呈多重耐药,尤其是对大环内酯-克林霉素抗菌药物耐药率高。因此应加强对MRSA耐药率的监测,合理选抗菌药物,从而减少MRSA的产生和传播。
Objective To investigate the charactistics on clinical distribution and antibiotic resistance of MRSA （ethicillin-resistant staphylococcus aureus ）, and provoid the advice on treatment to staphylococcus aureus （SA） infection. Methods Samples of MRSA were collected from all clinical departmentsin People＇s Hospitalof Suzhou National New ＆ Hi- Tech Industrial Development Zone, Jiangsu, China during Jan. 2015- Aug. 2017. Antibacterial susceptibility test was carried out by MIC method, and the character on clinical distribution and resistance of MRSA were discussed. Results Among 170 strains of SA isolated,40 isolates were identified as MRSA, which was 23.5 % of 170 SA isolates. The most isolateswere from respiratory unit （20 isolates）, being 50% ,followed by ICU, pediatrics and neurology. Multi-resistant MRSA isolates had high resistance to β-1actam antibiotics andmacrolides （resistance rate： 67. 5% ）. Resistance rate of clindamycin induced by erythromycin was 47.5% ,which suggested that those agents（macrolides,clindamycin） should not be used on MRSA infection in Suzhou area. There was low resistance rate on aminoglycosides and fluoroquinolones （resistant rate 〈 30% respectively）. Trimethoprim, sulfamethoxazole and rifampin had good activity to all isolates of MRSA tested, and no isolate of MRSA was found to be resistant to linezolid, vancomycin. Conclusion Number of MRSA isolates detected is lower and lower in recent 3 years in Suzhou area. MRSA isolates aremuti-resistance towards to antibiotics, and particularly have higher resistant rate to macrolides- clindamycinantibiotics. Therefore, it is necessary to strengthen the monitoring of MRSA tolerance rate and rationally choose antimicrobial agents so as to reduce the production and transmission of MRSA.
作者
赵蓉芬
张虹
秦玉红
朱建洲
张洪明
华道生
于农
邓淑文
ZHAO Rong- fen, ZHANG Hong, QING Yu- hong, ZHU Jian- zhou, ZHANG Hong- ming, HUA Dao- sheng, YU Nong, DENG Shu- wen(People＇s Hospital of Suzhou National New ＆ Hi- Tech Industrial, Suzhou 215129, China)
出处
《标记免疫分析与临床》
CAS
2018年第3期380-382,390,共4页
Labeled Immunoassays and Clinical Medicine
关键词
耐甲氧西林金黄色葡萄球菌
临床分布特点
耐药性
MRSA（ethicillin- resistant staphylococcus aureus）
Clinical distribution
Antibiotic resistance
