摘要
目的探讨耐甲氧西林金黄色葡萄球菌的临床分布及耐药性。方法选取2020年1月至2020年12月我院金黄色葡萄球菌感染患者临床样本329株,予全自动微生物分析仪检测,共检出100株耐甲氧西林金黄色葡萄球菌MRSA。药物敏感性检测方法:微量稀释法;参照标准:美国国家临床实验室标准委员会推荐标准(CLSI2019)。筛选方式:头孢西丁筛选试验阳性,共筛出100株MRSA。菌株的鉴定和药敏试验:VITEK2-Compact全自动微生物鉴定及药敏分析仪(法国梅里埃);药敏试验标准:CLSI抗菌敏感试验执行标准M100-S25文件;药敏质控菌株:金黄色葡萄球菌ATCC25923和ATCC29213。结果329株金黄色葡萄球菌中,MRSA共100株,占比30.39%(100/329)。其中,分布最高的ICU,占比20.00%(20/100);其次是神经外科,占比18.00%(18/100);最后是妇科、内分泌科、胃肠外科、心内科、肿瘤科,占比1.00(1/100)。MRSA的耐药率最高的青霉素G(100%)、苯唑西林(100%),其次是红霉素(74%)、克林霉素(39%)左旋氧氟沙星(38%)、四环素(38%)、环丙沙星(37%)、莫西沙星(37%)。半数以上药物的耐药性超过30%。结论在MRSA预防中,应着手于抗生素的合理使用,对MRSA菌株予以鉴定,同时合理用药,尤其MRSA易感患者、新入院患者,需加大监察力度,在ICU、神经外科等MRSA高发科室,还需选择最合理的检测方法,做到早发现、早诊断、早治疗MRSA感染,以提高临床治疗效果,减轻患者不必要的伤害,促进患者早日康复。
Objective To investigate the clinical distribution and drug resistance of methicillin-resistant staphylococcus aureus.Methods From January 2020 to December 2020,329 strains of MRSA were detected by automatic microbial analyzer in clinical samples of patients with staphylococcus aureus infection in our hospital.A total of 100 strains of MRSA were detected by methicillin-resistant staphylococcus aureus.Drug sensitivity test method:microdilution method.Reference standard:National Committee for Clinical Laboratory Standards Recommendations(CLSI 2019).Screening method:100 strains of MRSA were screened out by CEFOXITIN screening test.Identification and drug sensitivity test of strains:VITEK2-Compact automatic microbial identification and drug sensitivity analyzer(Meyrié,France).Drug sensitivity test standard:CLSI antibiotic sensitivity test implementation standard M100-S25 document;drug sensitivity control strains:staphylococcus aureus ATCC25923 and ATCC29213.Results The 329 staphylococcus aureus strains,100 strains of MRSA accounted for 30.39%(100/329).The highest proportion of ICU was 20.00%(20/100),followed by neurosurgery(18/100),the least is gynecology,endocrinology,gastroenterology,cardiology and oncology(1/100).The drug resistance rate of MRSA was highest in penicillin G(100%),oxacillin(100%),followed by erythromycin(74%),clindamycin(39%),levofloxacin(38%),tetracycline(38%),ciprofloxacin(37%)and moxifloxacin(37%).More than half of the drugs are more than 30%resistant.Conclusion In the prevention of MRSA,the rational use of antibiotics should be started,the strains of MRSA should be identified,at the same time,the rational use of drugs,especially MRSA susceptible patients,new hospitalized patients,need to increase surveillance,in ICU,neurosurgery and other departments with high incidence of MRSA,it is also necessary to select the most reasonable means of detection,early diagnosis,early treatment of MRSA infection,to improve clinical treatment,reduce patients unnecessary injury,promote patients to recover as soon as possible.
作者
顾丽萍
GU Liping(Department of Laboratory Medicine,Zhangjiagang N0.1 People's Hospital Affiliated to Soochow University,Suzhou 215600,China)
出处
《中国医药指南》
2021年第33期58-60,共3页
Guide of China Medicine
关键词
耐甲氧西林金黄色葡萄球菌
临床分布
耐药性
Methicillin-resistant staphylococcus aureus
Clinical distribution
Drug resistance
