摘要
目的研究临床分离的金黄色葡萄球菌(SA)耐药性及流行趋势。方法收集本院临床分离的SA,并使用Mi-croScan WalkAway-40SI全自动微生物分析仪进行鉴定,药敏试验采用MIC法及K-B法。应用WHONET 5.6软件及SPSS 18.0软件对数据进行统计分析。结果 3年间共分离SA 452株,其中耐甲氧西林金黄色葡萄球菌(MRSA)221株,检出率为48.9%。MRSA的检出率从2009年的32.8%升至2011年的51.3%,呈显著上升趋势(χ2=34.210,P<0.01)。SA主要分离自神经外科(70株,15.5%)、呼吸内科(43株,9.5%)、ICU(38株,8.4%)和普通外科(38株,8.4%),其中神经外科MRSA的检出率连续3年均高于70.0%;各类临床标本中,痰标本中分离的MRSA最多(230株,50.9%),其次为脓液标本(147株,32.5%),且脓液标本中MRSA检出率呈逐年上升趋势(χ2=11.280,P<0.01)。甲氧西林敏感金黄色葡萄球菌(MSSA)对常用的抗菌药物耐药率较低,除氨苄西林、红霉素外,其耐药率均低于20.0%,而MRSA对常用的抗菌药物均有较高的耐药率,但其对庆大霉素、环丙沙星的耐药率呈下降趋势(P<0.01)。未检出万古霉素、利奈唑胺耐药株。结论 SA的临床分离率有升高趋势,应加强对其耐药性监测,以指导临床合理用药并有效防控SA,特别是MRSA的院内感染。
Objective To analyze the clinical epidemic tendency and antimicrobial resistance of Staphylococcus au- reus （SA） isolated from clinical samples. Methods SA isolated from clinical samples were identified with Mi- croScan walkaway-40SI automatic microbial analyzer; antimicrobial susceptibility testing was performed by MIC and disk diffusion method,and the data were analyzed with WHONET 5.6 and SPSS 18.0. Results A total of 452 strains SA were isolated, 221 strains （48.9%） of which were MRSA in recent three years. The detection rate of MRSA increased from 32. 8% to 51.3 % in 2009 -2011, displaying a statistically significant upward trend （X2 = 34. 210,P 〈0.01）. SA strains were mainly isolated from department of neurosurgery （70 strains, 15.5% ） , De- partment of Respiratory Medicine （43 strains, 9.5% ） , ICU （38 strains, 8.4% ） and department of general sur- gery （38 strains, 8.4% ） ; the detection rates of MRSA isolated from department of neurosurgery were higher than 70. 0% for three consecutive years. In all kinds of clinical specimens, SA were mainly isolated from sputum speci- mens （230 strains, 501 9% ） and pus specimens （ 147 strains, 32. 5% ）. the detection rates of MRSA isolated from pus specimens showed an increasing trend （X2 = 11. 280, P 〈 0.01 ）. The resistant rates of methicillin-sensitive Staphylococcus aureus （MSSA） to the commonly used antimicrobial agents were lower than 20. 0% except for ampi- cillin and erythromycin. Methicillin-resistant Staphylococcus aureus （MRSA） had been resistant to the commonly used antimierobial agents in higher degree, But there was a decreasing tendency in resistant rates of gentamicin and ciprofloxacin （P 〈 0. 01 ）. Moreover no strainswere resistant to vancomycin and linezolid. Conclusion The isola- ted rate of SA display an upward trend. Monitoring of drug-resistance of SA should be strengthened significantly. And it is essential to strengthen the isolation measures and make reasonable use of antibiotics in ord
出处
《安徽医科大学学报》
CAS
北大核心
2013年第4期409-412,共4页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81171662)
安徽省卫生厅科学基金资助项目(编号:2010C057)
安徽省高等学校省级自然科学研究项目(编号:KJ2012Z156)
安徽医科大学校科研基金项目(编号:2012XKJ077)
关键词
金黄色葡萄球菌
耐甲氧西林金黄色葡萄球菌
耐药性监测
Staphylococcus aureus
methicillin-resistant Staphylococcus aureus
bacterial resistant surveillance
