摘要
目的分析医院金黄色葡萄球菌(SAU)耐药性的变化,为临床合理选用抗菌药物提供依据。方法收集2007年1月-2009年12月临床标本中分离的SAU,药敏试验及耐甲氧西林金黄色葡萄球菌(MRSA)鉴定采用Phoenix-100型全自动细菌分析仪,诱导克林霉素耐药采用纸片法,判断标准均按CLSI 2009年规定标准判定。结果痰、脓液、血液及分泌物为SAU的主要标本来源,ICU、呼吸科、神经外科、血液科为SAU的主要病区;临床标本MRSA及诱导克林霉素耐药检出率逐年升高,MRSA感染死亡率逐年升高;214株SAU中利福平的耐药率<15.5%,除青霉素>90.0%外,对其他抗菌药物耐药率均<80.0%;阿莫西林/克拉维酸、环丙沙星、克林霉素2008、2009年耐药率与2007年相比,差异均有统计学意义(P<0.05),庆大霉素、利福平2009年耐药率与2007年相比,差异均有统计学意义(P<0.05);3年MRSA对大环内酯类、氨基糖苷类、喹诺酮类抗菌药呈多药耐药,且耐药率均>80.0%。结论 3年SAU的耐药率持续保持较高的水平,并且MRSA的检出率有逐年上升的趋势,要求临床应合理使用抗菌药物,并动态监测其耐药性的变迁。
OBJECTIVE To analyze the trends of the drug resistance of Staphlococcus in hospital during the period of Jan 2007 to Dec 2009 and to provide basis for rational use of antibiotic agents. METHODS The Staphylococcus aureus strains isolated from clinics were collected. Identification of MRSA and drug susceptibility test were performed by Phoenix-100 automatic analysis system from U. S. BD company. Clindamycin resistance was induced by using disk diffusion method. The results were judged according to CLSI （2009） sets out criteria~ MRSA in vancomycin MIC value changes were monitored by using broth dilution method. RESULTS Sputunl, pus, blood, and secretions samples were the main source of 8AU. ICU. Respiratory, neurological surgery and hematology were the main wards of S. aureus. The highest detection rate of MRSA was in ICU. The MRSA detection rate and detection rate of induced resistance to clindamycin increased year by year, so did the mortality of MRSA infection. No vancomycin-resistant strains and teicoplanin-resistant strains were detected in 214 strains of S. aureus. Resistance rates of SAU strains to rifampici were lower than 15.5%, while resistance rates of SAU strains to penicillin were higher than 90.0%. Resistance rates to other antibiotics in 2008 and 2009 were generally less than 80. 0%, compared with 2007, the resistance rates of SAU to amoxicillin/clavulanic acid, ciprofloxacin, clindamycin in the 3 years had statistically significant differences （P〈0. 05）, the resistance rates of SAU to gentamicin and rifampicin between 2007 and 2009 had statistically significant difference （P〈0.05）. Three years of continuous monitoring showed that MRSA were multi-drug resistant to macrolides, aminoglycosides and quinolones, and the resistance rates were all above 80. 0%. No vancomycin resistant strains was detected. CONCLUSION The resistant rates of SAU maintain a high level in last three years, and the detection rate of MRSA shows an upward trend year by year. Clinical doctors should be requested to u
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第5期1027-1029,共3页
Chinese Journal of Nosocomiology
基金
唐山市科技局科研课题(2009202a-3-29)
