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目的:回顾性分析浙江省海宁市人民医院2012—2015年间分离的金黄色葡萄球菌的临床分布及耐药情况,为探讨防治策略提供参考。方法:收集某医院2012年—2015年分离的1 121株金黄色葡萄球菌,采用VITEK2Compact全自动微生物分析仪进行菌株鉴定和药敏试验。通过纸片琼脂扩散法筛选出耐甲氧西林金黄色葡萄球菌(MRSA)。以WHONET 5.6版软件对统计数据进行讨论分析。结果:1 121株金黄色葡萄球菌中,标本来自痰液870株(77.6%);脓液141株(12.6%);穿刺引流液40株(3.6%);血液38株(3.4%)。临床分布主要以ICU 357株(31.8%),儿科284株(25.3%),呼吸科240株(21.4%)为主。共检出MRSA 321株(28.3%)。药敏试验结果显示金黄色葡萄球菌具有多重耐药性,耐药率最高的为青霉素(4年总体耐药率为92.1%),其次是红霉素(55.0%),四环素(24.5%)和克林霉素(21.0%),所有菌株对万古霉素、呋喃妥因、利奈唑胺、替加环素、奎奴普丁/达福普汀敏感。MRSA对青霉素、头孢西丁、红霉素、四环素、克林霉素、左氧氟沙星和庆大霉素的耐药率均高于甲氧西林敏感金黄色葡萄球菌(MSSA)。结论:金黄色葡萄球菌造成的医院感染不容乐观,具有多重耐药性,临床医务工作者需根据药敏结果对MRSA感染制定合理有效的抗菌治疗措施,加强对MRSA的预防隔离和耐药性监测。
Objective: To retrospectively analyze the clinical distribution and drug resistance of Staphylococcus aureus isolated in Haining People’s Hospital of Zhejiang Province from 2012 to 2015, and to provide reference for the prevention and treatment strategies. Methods: A total of 121 strains of Staphylococcus aureus isolated in a hospital from 2012 to 2015 were collected and identified by VITEK2 Compact automatic microbiological analyzer. Methicillin-resistant Staphylococcus aureus (MRSA) was screened by disk agar diffusion method. To WHONET 5.6 version of the software to discuss the statistical analysis. Results: Among the 121 strains of Staphylococcus aureus, 870 (77.6%) were sputum, 141 (12.6%) were pus, 40 (3.6%) were puncture drainage and 38 (3.4%) were blood. The clinical distribution mainly consisted of 357 ICU strains (31.8%), 284 pediatric patients (25.3%) and 240 respiratory patients (21.4%). A total of 321 MRSA strains (28.3%) were detected. Susceptibility test results showed that Staphylococcus aureus was multi-drug resistant. The highest drug resistance rate was penicillin (overall resistance rate was 92.1% at 4 years), followed by erythromycin (55.0%), tetracycline (24.5%) and Clindamycin (21.0%), all strains were sensitive to vancomycin, nitrofurantoin, linezolid, tigecycline, quinupristin / dalfatin. MRSA resistance to penicillin, cefoxitin, erythromycin, tetracycline, clindamycin, levofloxacin and gentamicin were higher than methicillin-sensitive Staphylococcus aureus (MSSA). Conclusions: Nosocomial infection caused by Staphylococcus aureus is not optimistic and multi-drug resistant. Clinicians need to develop rational and effective antibacterial treatment measures for MRSA infection based on drug susceptibility results, and to strengthen the prevention and isolation and drug resistance monitoring of MRSA .