【摘要】：目的探討青島大學附屬醫(yī)院耐甲氧西林葡萄球菌的臨床分布、標本來源及耐藥狀況。方法收集2011~2013年臨床分離的2 240株葡萄球菌屬,采用全自動微生物分析系統(tǒng)VTEK2-compact60對菌種進行鑒定及藥敏分析,用K-B法進行藥敏補充試驗。結(jié)果葡萄球菌屬的構(gòu)成比中前3位分別為金黃色葡萄球菌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;從858株金黃色葡萄球菌分離出MRSA 456株(53.15%);1 382株凝固酶陰性葡萄球菌分離出MRCNS 1 099株(79.52%);耐甲氧西林葡萄球菌的標本來源主要為內(nèi)科和ICU的痰液、導管、分泌物及血液等標本;MRSA和MRCNSR對青霉素G、頭孢吡肟、頭孢唑啉、頭孢噻肟3年耐藥率均為100%;對克林霉素、慶大霉素、四環(huán)素的耐藥率均高于60%;對萬古霉素、利奈唑胺、替加環(huán)素、替考拉寧、呋喃妥因、喹奴普汀/達福普汀耐藥率均0%;對喹諾酮類藥物的耐藥性是先上升后下降;對利福平的耐藥性是逐年上升且大于50%。結(jié)論耐甲氧西林葡萄球菌的耐藥的復雜性和多重性呈逐年上升的趨勢,醫(yī)院必須加強葡萄球菌耐藥性的檢測,為臨床醫(yī)師和實驗室人員提供指導,并根據(jù)藥敏結(jié)果規(guī)范合理使用抗生素,才能有效地控制耐藥菌的產(chǎn)生和院內(nèi)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.
【作者單位】： 青島大學醫(yī)學院附屬醫(yī)院;
【基金】：國家自然科學基金項目(81373001)
【分類號】：R446.5

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