摘要
目的比较分析烧伤科与骨科住院患者创面感染葡萄球菌的分布及耐药性差异,为临床合理选用抗菌药物提供参考依据。方法收集2011—2015年烧伤科与骨科患者创面分泌物送检,采用Micro Scan Walk Away-96 plus全自动微生物分析系统进行细菌鉴定及药敏试验,共测定20种抗菌药物敏感性,采用WHONET 5.6和SPSS 19.0软件统计分离出的非重复性感染细菌种类并进行耐药性分析。结果5年间烧伤科共分离出革兰阳性菌202株,其中金黄色葡萄球菌(Staphylococcus aureus,SA)110株(54.46%)、凝固酶阴性葡萄球菌(CNS)78株(38.61%),骨科共分离出革兰阳性菌725株,其中SA 310株(42.76%)、CNS 357株(49.24%)。烧伤科SA检出率明显高于骨科(P<0.005),而骨科CNS检出率高于烧伤科(P<0.05)。烧伤科检出甲氧西林耐药金黄色葡萄球菌(MRSA)85株,占SA的77.27%(85/110),骨科检出MRSA 99株,占SA的31.94%(99/310),二者有显著差别(P<0.001)。烧伤科检出甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)74株,占C NS的94.87%(74/78),骨科检出MRCNS 266株,占CNS的74.50%(266/357),二者有显著差别(P<0.001)。烧伤科和骨科SA分别有10种和2种耐药率>50.0%、CNS分别有9种和4种耐药率>50.0%。烧伤科SA有10种耐药率均明显高于骨科(P<0.05),但有1种奎奴普丁/达福普汀耐药率明显低于骨科(P<0.05)。烧伤科CNS有7种耐药率均明显高于骨科(P<0.05)。未发现对万古霉素耐药葡萄球菌。结论烧伤科与骨科住院患者创面感染葡萄球菌构成比及耐药性有较大差异,多重耐药普遍,烧伤科葡萄球菌耐药性比骨科强、MRSA也更为严重,临床应根据药敏试验结果合理选用抗菌药物,万古霉素仍是治疗多重耐药葡萄球菌感染的首选药物。
Objective A comparative analysis of the distribution and drug resistance of Staphylococci on the surface of the wound of bum inpatients and orthopaedics inpatients was made, in order to provide some reference for clinic about selecting antimicrobial agents. Methods Collect the wound seereta of bum inpatients and orthopaedics inpatients during 2011--2015 for bacterial identification and susceptibility testing by MieroScan WalkAway-96 plus automated microbial analysis system. A total of 20 antimierobial agents were tested. Statistical analysis about the bacterial species of non-repetitive infection and their drug resistance was made with WHONET 5.6 and SPSS 19.0 statistical software. Results The Gram-positive bacteria strains isolated from the surface of the wound from bum inpatients during 2011--2015 were 202, including 110（54.46%） strains ofS. aureus and 78（38.61%） of coagulase-negative Staphylococcus（CNS）. The Gram-positive bacteria strains isolated from orthopaedics inpatients were 725, including 310 （42.76%） strains of S. aureus and 357（49.24%） of CNS. The detectable rate of S. aureus in burn unit was significantly higher than that in orthopaedics unit（P〈0.005）, and the detectable rate of CNS in orthopaedics unit was higher than that in burn unit（P〈0.05）. 85 strains of MRSA were detected in burn unit, accounted for 77.27% （85/110） of S. aureus. 99 strains of MRSA were detected in orthopaedies unit, accounted for 31.94%（99/310） of S aureus. A significant difference could be seen between them（P〈 0.001）. 74 strains ofMRCNS were detected in bum unit, accounted for 94.87%（74/78） of CNS. 266 strains of MRCNS were detected in orthopaedics unit, accounted for 74.50%（266/357） of CNS. There was also a significant difference between them（P 〈0.001）. There were 10 and 2 antibiotics with resistance rates〉50.0% on S. aureus in burn and orthopedics, and 9 and 4 on CNS, respectively. For 10 antibiotics, the resistance rates ofS. aureus in bum were significantly high
出处
《国外医药（抗生素分册）》
CAS
2017年第2期62-66,89,共6页
World Notes on Antibiotics
