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目的分析四川省肿瘤专科医院金黄色葡萄球菌(SAU)及耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及耐药性,为临床合理使用抗菌药物提供依据。方法收集2011—2016年肿瘤专科医院住院肿瘤患者的764株SAU,用Auto-Scan4细菌鉴定及药敏分析系统对菌落进行菌种鉴定及药敏试验。结果 764株SAU中检出MRSA 176株,占23.04%,6年间MRSA的检出率呈上升趋势;SAU主要分离自痰液、伤口和分泌物,分别占30.89%、19.63%和14.40%;MRSA分布最多的病区是ICU、骨科病区和胸科病区,分别占73.81%、46.43%和40.91%;SAU对青霉素的耐药率最高(>95%),对万古霉素和利奈唑胺的耐药率最低,均为0;MRSA对喹诺酮类药物、红霉素及克林霉素耐药率>70%,对其他大部分药物耐药率明显高于甲氧西林敏感金黄色葡萄球菌(MSSA)。结论肿瘤专科医院的SAU耐药率较高,且MRSA的检出有逐年增高趋势,临床应合理使用抗菌药物,定期监测其耐药性变迁,以避免院内传播。
Objective To analyze the clinical distribution and drug resistance of Staphylococcus aureus (SAU) and methicillin-resistant Staphylococcus aureus (MRSA) in Sichuan Cancer Hospital and provide evidence for the rational use of antimicrobial agents in clinic. Methods A total of 764 SAU inpatients with oncology cancer from 2011 to 2016 were collected. The strains were identified by means of Auto-Scan4 and drug susceptibility analysis system. Results There were 176 strains of MRSA detected in 764 strains of SAU, accounting for 23.04%. The detection rate of MRSA showed an upward trend in 6 years. SAU was mainly isolated from sputum, wounds and secretions, accounting for 30.89%, 19.63% and 14.40% respectively. MRSA The most frequently distributed wards were ICU, orthopedic ward and thoracic ward, accounting for 73.81%, 46.43% and 40.91% respectively; SAU had the highest rate of resistance to penicillin (> 95%), vancomycin and linezolid Were the lowest, all of which were 0. The resistance rate of MRSA to quinolones, erythromycin and clindamycin was over 70%, and the drug resistance rate to most other drugs was significantly higher than that of methicillin-sensitive Staphylococcus aureus (MSSA). Conclusions The rate of SAU resistance in cancer specialist hospitals is high, and the detection rate of MRSA is increasing year by year. Antibiotics should be used rationally and the change of drug resistance should be regularly monitored to prevent the spread of nosocomial infection.