1874株金黄色葡萄球菌临床分布及耐药性结果分析

Analysis of clinical distribution and drug resistance of 1874 strains of Staphylococcus aureus

中文关键词:  金黄色葡萄球菌  甲氧西林敏感金黄色葡萄球菌  耐甲氧西林金黄色葡萄球菌  分布  耐药性

英文关键词:Staphylococcus aureus  methicillin sensitive Staphylococcus aureus  methicillin resistant Staphylococcus aureus  distribute  resistance

中文摘要:

      目的 了解四川省某医院甲氧西林敏感金黄色葡萄球菌(methicillin sensitive Staphylococcus aureus, MSSA)与耐甲氧西林金黄色葡萄球菌(methicillin resistant Staphylococcus aureus, MRSA)的临床科室分布和耐药性情况。方法 回顾性分析2014年12月?2017年12月四川省某医院门诊及住院患者, 包括8名因金黄色葡萄球菌引起的食物中毒患者, 送检各类标本分离出SA(Staphylococcus aureus)可疑菌落1874株, 对其进行鉴定和药敏检测。结果 MSSA和MRSA标本主要来源于痰液(51.31%, 74.33%)、伤口分泌物(21.52%, 8.96%)和脓液(10.07%, 7.92%)。725株MSSA临床分离率依次为门诊(27.17%)、呼吸科(15.45%)、ICU(10.21%)、神经科(8.55%)和口腔科(5.52%), 1149株MRSA依次为ICU(33.16%)、神经科(11.66%)、呼吸科(9.75%)、儿科(7.57%)和妇产科(6.27%)。耐药性结果表明, MSSA对苯唑西林、万古霉素、利奈唑胺、替考拉林敏感, 对青霉素G、红霉素和阿莫西林/克拉维酸耐药率依次为89.38%、56.69%、21.51%外, 对其他抗菌药耐药率均＜18.00%; MRSA对万古霉素利、奈唑胺、替考拉林敏感, 对苯唑西林、莫西沙星、克林霉素、红霉素、青霉素G、四环素、环丙沙星、阿莫西林/克拉维酸和氨苄西林/舒巴坦的耐药率均显著高于MSSA。结论 四川省某医院2014年12月?2017年12月期间临床分离的SA以MRSA为主, MSSA和MRSA在标本来源、科室分布等方面存在较大差异, MRSA耐药情况更为严重, 明显高于MSSA。若要评估金黄色葡萄球菌感染风险以及病人的治疗方案, 应分别考虑MRSA和MSSA的感染来源和耐药性。

英文摘要:

      Objective To investigate the clinical distribution and drug resistance of methicillin sensitive Staphylococcus aureus (MSSA) and methicillin resistant Staphylococcus aureus (MRSA) in a hospital in Sichuan province. Methods The outpatients and inpatients in a hospital in Sichuan province from December 2014 to December 2017 were retrospectively analyzed, including 8 patients with food poisoning caused by Staphylococcus aureus, and 1874 strains of SA (Staphylococcus aureus) suspicious colonies were isolated from all specimens for identification and drug sensitivity detection. Results MSSA and MRSA specimens were mainly obtained from sputum (51.31%, 74.33%), wound secretions (21.52%, 8.96%) and pus (10.07%, 7.92%). The clinical isolation rate of 725 MSSA strains was outpatient (27.17%), respiratory (15.45%), ICU(10.21%), neurology (8.55%) and stomatology (5.52%), and 1149 MRSA strains were ICU (33.16%), neurology (11.66%), respiratory (9.75%), paediatrics (7.57%) and obstetrics and gynecology (6.27%), respectively. MSSA was sensitive to benzocillin, vancomycin, linezolid, tapocin, and the drug resistance rates to penicillin G, erythromycin and amoxicillin/clavuric acid were 89.38%, 56.69% and 21.51%, respectively, and to other antibiotics were all less than 18.00%. MRSA was sensitive to vancomycin, nezolid and tetracycline, and the drug resistance rates of benzocillin, moxifloxacin, clindamycin, erythromycin, penicillin G, ciprofloxacin, amoxicillin/clavulacin and ampicillin/sulbactam were significantly higher than those of MSSA. Conclusion From December 2014 to December 2017, the clinical separation of SA in a hospital in Sichuan province is with MRSA as predominant. There are significant differences between MSSA and MRSA in specimen source and clinical distribution. The drug resistance of MRSA is more serious, significantly higher than that of MSSA. The source of infection and drug resistance of MRSA and MSSA should be considered to assess the risk of Staphylococcus aureus infection and the patient's treatment regimen.