摘要
目的了解医院呼吸内科ICU、急诊ICU和神经外科ICU感染葡萄球菌属的分布及耐药性,为ICU医院感染的预防与控制措施的制定提供理论依据。方法收集2006年7月-2008年7月医院呼吸科、急诊科和神经外科ICU患者的各种标本包括痰、血液、中段尿、分泌物、脓液分离的葡萄球菌属,对其分布、MRSA的检出以及药敏结果进行分析。结果共采集临床标本720例次,以痰标本居多,368例次,占51.11%;共分离葡萄球菌属171株,其中金黄色葡萄球菌居多,76株,占44.44%,表皮葡萄球菌次之,48株,占28.07%,76株金黄色葡萄球菌中,MRSA 44株,占57.89%,MSSA 32株占42.11%;MRSA对万古霉素和去甲万古霉素100.00%敏感外,对大部分抗菌药物耐药,对氯霉素和米诺环素的耐药率较低,均为20.45%;MSSA对抗菌药物的耐药率相对较低,对万古霉素和去甲万古霉素均100.00%敏感,其次是头孢唑林、阿米卡星和米诺环素,耐药率分别为6.25%、6.25%和10.00%。结论MRSA对临床常用抗菌药物耐药性较高,往往对几类抗菌药物同时耐药,一旦发现可疑病例即实施隔离,同时进行病原学的检查,强化手卫生,是预防与控制ICU内MRSA医院感染的重要措施。
OBJECTIVE To investigate the resistance of Staphylococcus aureus,includ MRSA and MSSA,to antimicrobial agents in intensive care unit（ICU）,and to provide basis for clinical therapy.METHODS K-B disk diffusion method was used to determine the drug susceptibility of 171 strains of S.aureus,and meticillin-resistant S.aureus（MRSA） was detected by using the disk diffusion method according to NCCLS/CLSI.RESULTS In ICU,S.aureus was isolated mostly from the respiratory tract,urine tract and blood.MRSA made up 57.89%.For MRSA and MSSA,no resistance against vancomycin and norvancomycin was observed.The resistance rates of MRSA to other agents were as follows： chloramphenicol 20.45%,and minocycline 20.45%.While the resistance rates of MSSA to other agents were as follows：cefazolin 6.25%,and amikacin 6.25%,minocycline 9.38%.CONCLUSIONS MRSA shows the multidrug resistance.Pathogenic monitoring,keeping the patients apart,rational utilization of antibiotics,medical facility sterilization strictly and intensive hand hygiene are very important to prevent MRSA infection.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第23期3278-3280,共3页
Chinese Journal of Nosocomiology
关键词
耐甲氧西林金黄色葡萄球菌
多药耐药
预防措施
Meticillin-resistant Staphylococcus aureus
Drug resistance
Preventive measures
