脓液中金黄色葡萄球菌的耐药性监测

摘要

Objective To analyze drug resistance of Staphylococcus aureus pus.Methods Totally 227 strains of Staphylococcus aureus isolated from clinic in People's hospital of Inner Mongolia Autonomous Region from January 2009 to March 2013 were analyzed; the bacteria identification and drug sensitivity test were made by VITEK 2 Compact automatic bacteria identification instrument.Results Staphylococcus aureus in pus was fotnd from department of surgery,orthopedics department and general surgery department,accounting for 52.0％ (118/227).Separation rate of methicillin-resistant staphylococcus aureus (MRSA) in pus was 34.4％,which was lower than that of various samples MRSA reported in the literature of our hospital [66.0％ (194/294)] (P ＜ 0.05).Drug resistance rate of Staphylococcus aureus in pus to linezolid,vancomycin,teicoplanin,quinupristin/Dafoe leptin and nitrofurantoin was 0; drug resistance rate of MRSA was lower than that of SA to methicillin (MSSA) (P ＜0.05),and higher than that of the other antibacterial agents (P ＜ 0.05).Drug resistance rate of SA of Beta-lactamase positive and negative to nitrofurans and glycopeptides was 0.Drug resistance rate of SA of Beta-lactamase positive to penicillin G [98.0％ (198/202)] was higher than that of Beta-lactamase negative [68.0％ (17/25)],there was significant difference (P ＜ 0.05).Conclusion The detection rate and the drug resistance of MRSA in pus are high.%目的 分析脓液中金黄色葡萄球菌(SA)的耐药性.方法 对内蒙古自治区人民医院2009年1月至2013年3月临床分离的227株金黄色葡萄球菌进行分析,细菌鉴定和药敏试验采用法国梅里埃威泰科VITEK 2 Compact全自动细菌培养鉴定仪.结果 脓液中SA的病区来源主要为外科系统,骨科和普外科占52.0％ (118/227),脓液中耐甲氧西林金黄色葡萄球菌(MRSA)的分离为34.4％ (78/227),低于本院文献报道各种标本MRSA的分离率66.0％ (194/294) (P ＜0.05).脓液中SA对利奈唑胺、万古霉素、替考拉宁、奎奴普丁/达福普汀和呋喃妥因的耐药率均为0,MRSA对复方新诺明的耐药率低于对甲氧西林敏感的SA(MSSA) (P ＜0.05),对其他抗菌药物MRSA的耐药性高于MSSA(P＜0.05).β-内酰胺酶阳性和阴性的SA对呋喃类药物和糖肽类药物的耐药率均为0,对青霉素G耐药率前者98.0％ (198/202)高于后者68.0％(17/25),差异有统计学意义(P＜0.05),对其他抗菌药物的耐药率,前者略高于后者,但差异无统计学意义(P＞0.05).结论 脓液中MRSA的检出率和耐药性较高,临床应继续加强无菌区MRSA的感染控制.