摘要
目的探讨该院2013-2017年耐甲氧西林金黄色葡萄球菌(MRSA)的临床分离情况及耐药性变化趋势,为指导临床合理用药提供实验依据。方法采用VITEK-2Compact型全自动细菌培养鉴定仪对细菌进行鉴定和药敏检测,以WHONET5.6软件进行数据分析。结果 2013-2017年MRSA的检出率分别为26.2%、34.4%、36.4%、48.3%、54.3%,呈上升趋势。277株MRSA各病区分布外科病区占56.0%、儿科病区占25.6%、内科病区占16.6%、重症监护室占1.8%;标本分布分泌物105株、痰及肺泡灌洗液78株、脓液74株、血液10株、其他类型标本10株;药敏结果显示,277株MRSA对青霉素、红霉素和克林霉素等抗菌药物的耐药率在80%以上,而对四环素、复方新诺明、莫西沙星、左氧氟沙星和环丙沙星等抗菌药物的耐药率较低(<80%);5年间MRSA对红霉素、克林霉素、复方新诺明、莫西沙星、左氧氟沙星和环丙沙星的耐药率比较,差异有统计学意义(P<0.05)。结论该院MRSA检出率较高且逐年增加,主要来源为外科病区的非无菌标本,5年间检出的MRSA对多种抗菌药物耐药率高且耐药率波动明显,因此,在了解本地区MRSA的流行病学变化和监测其耐药性变迁的基础上,应加强院内MRSA耐药性监测、规范临床用药以减缓或避免MRSA的流行播散。
Objective To investigate the trend of clinical isolation of methicillin-resistant Staphyloco- ccus aureus （MRSA） and its drug resistance to antibiotics in our hospital from 2013 to 2017,so as to provide evidence for rational use of antibiotics in clinic. Methods All strains were identified by VITEK-2 Compact,and the data were analyzed with WHONET5.6 software. Results The isolation rate of MRSA was increasing from 2013 to 2017,accounting for 26.2%,34.4%,36.4%,48.3% and 54.4%,respectively.277 strains of MRSA were isolated from department of surgery（56.0%）,pediatric ward （25.6%）,department of internal medicine （9.5%）and intensive care unit（ICU）（1.8%）,and from samples of secretions（105）,sputum and alveolar lavage fluid （74）,pus （78）,blood（10）and other types（10）.The resistance rates of MRSA to penicillin,erythromycin and clindamycin （〉80%） were higher than that to tetracycline,cotrimoxazole,moxifloxacin,levofloxacin and ciprofloxacin （〈80%）.The resistance rates of MRSA to erythromycin,clindamycin,cotrimoxazole,moxifloxacin,levofloxacin and ciprofloxacin were significantly different in five years （ P 〈0.05）. Conclusion The isolation rate of MRSA in our hospital was high and increased year by year,and strains of MRSA were isolated mainly from non-sterile specimens of surgery patients.MRSA were highly resistant to multiple antibiotics and the resistance rates changed over the years.Therefore,on the basis of understanding the changes of epidemiology of MRSA infection and resistance in the local area,surveillance of MRSA resistance should be strengthened and use of antibiotics in clinic should be standardized,thus reducing or avoiding the spread of MRSA.
作者
王杉
董剑
杨静
谢铌奇
徐启峰
潘莉娟
欧国平
田时志
WANG Shan;DONG Jian;YANG Jing;XIE Niqi;XU Qifeng;PAN Lijuan;OU Guoping;TIAN Shizhi(Department of Clinical Laboratory,The People′s Hospital of Dazu District,Dazu,Chongqing 402360,China)
出处
《国际检验医学杂志》
CAS
2018年第17期2143-2146,共4页
International Journal of Laboratory Medicine
基金
重庆市卫生和计划生育委员会基金资助项目(20143065)
大足区科学技术委员会基金资助项目(DZKJ
2015ACC1017)
关键词
耐甲氧西林金黄色葡萄球菌
检出率
临床分布
耐药性变迁
methicillin resistant staphylococcus aureus
isolation rate
clinical distribution
resistance changes
