医院耐甲氧西林葡萄球菌的耐药监测及分析

发布时间：2018-08-02 09:01

【摘要】：目的探讨青岛大学附属医院耐甲氧西林葡萄球菌的临床分布、标本来源及耐药状况。方法收集2011~2013年临床分离的2 240株葡萄球菌属,采用全自动微生物分析系统VTEK2-compact60对菌种进行鉴定及药敏分析,用K-B法进行药敏补充试验。结果葡萄球菌属的构成比中前3位分别为金黄色葡萄球菌858株,占38.30%、表皮葡萄球菌721株,占32.19%、人葡萄球菌223株,占9.96;从858株金黄色葡萄球菌分离出MRSA 456株(53.15%);1 382株凝固酶阴性葡萄球菌分离出MRCNS 1 099株(79.52%);耐甲氧西林葡萄球菌的标本来源主要为内科和ICU的痰液、导管、分泌物及血液等标本;MRSA和MRCNSR对青霉素G、头孢吡肟、头孢唑啉、头孢噻肟3年耐药率均为100%;对克林霉素、庆大霉素、四环素的耐药率均高于60%;对万古霉素、利奈唑胺、替加环素、替考拉宁、呋喃妥因、喹奴普汀/达福普汀耐药率均0%;对喹诺酮类药物的耐药性是先上升后下降;对利福平的耐药性是逐年上升且大于50%。结论耐甲氧西林葡萄球菌的耐药的复杂性和多重性呈逐年上升的趋势,医院必须加强葡萄球菌耐药性的检测,为临床医师和实验室人员提供指导,并根据药敏结果规范合理使用抗生素,才能有效地控制耐药菌的产生和院内流行。
[Abstract]:Objective to investigate the clinical distribution, origin and drug resistance of methicillin resistant Staphylococcus in Qingdao University. Methods A total of 2240 strains of Staphylococcus were collected from 2011 to 2013. The strains of Staphylococcus were identified and drug sensitive analysis was carried out by VTEK2-compact60, K-B method was used for drug sensitivity supplementation test. Results 858 strains of Staphylococcus aureus, 721 strains of Staphylococcus epidermidis, 32.19 strains of Staphylococcus epidermidis and 223 strains of human staphylococcus were found in the first three genera of Staphylococcus aureus. MRSA 456 strains (53.15%) were isolated from 858 strains of Staphylococcus aureus and 1 382 strains of coagulase-negative staphylococcus were isolated from MRCNS 1 099 strains (79.52%). The resistance rates of MRSA and MRCNSR to penicillin G, cefepime, cefazolin, cefotaxime and cefotaxime in three years were 100; to clindamycin, gentamycin and tetracycline were all higher than 60%; to vancomycin, linazolamine, tegacycline, the drug resistance rates of MRSA and MRCNSR to penicillin G, cefepime, cefotaxime and cefotaxime were 100; The resistance rate of teicoplanin, furantoin, quinoplatin / dafopudine was 0; the resistance to quinolones increased first and then decreased; the resistance to rifampicin increased year by year and was more than 50%. Conclusion the complexity and multiplicity of methicillin-resistant staphylococci is increasing year by year. It is necessary to strengthen the detection of staphylococci resistance in hospitals in order to provide guidance for clinicians and laboratory personnel. The rational use of antibiotics according to the results of drug sensitivity can effectively control the production of drug-resistant bacteria and the prevalence in the hospital.
【作者单位】：青岛大学医学院附属医院;
【基金】：国家自然科学基金项目(81373001)
【分类号】：R446.5

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