某院耐甲氧西林金黄色葡萄球菌临床分离株的分布与抗生素敏感性分析
|
摘要
目的分析某院耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布和耐药性特点。方法收集该院2014年-2017年微生物室分离的MRSA,运用WHONET 5.6软件分析其临床分布、标本类型和药敏情况。结果共收集到MRSA 311株,标本类型主要为痰液179株,占57.6%;分泌物87株,占28.0%;血液17株,占5.5%。临床科室分布主要为神经外科92例,占29.6%;儿科49例,占15.8%;ICU 47例,占15.1%;骨科28例,占9.0%。药敏试验显示,MRSA对万古霉素、利奈唑胺、替加环素、奎奴普丁/达福普汀有很高的敏感率,达99%以上,对其余多种抗菌药均产生程度不同的耐药性。结论 MRSA耐药性强,抗生素滥用、免疫力低下患者、创伤性治疗是其感染的危险因素,因此应加强监测,合理使用抗生素,减少和控制MRSA菌株的产生和传播。
Objective To analyze the infection and drug resistance of methicillin resistant Staphylococcus aureus(MRSA) in a hospital. Methods MRSA were collected from 2014 to 2017, and the clinical distribution, specimen type and drug susceptibility were analyzed. Results Among the 311 MRSA strains, 179 strains came from phlegm, accounting for 57.6%, 87 strains from secretions, accounting for 28.0%, 17 strains from blood, accounting for 5.5%. According to the distribution in clinical departments, 92 cases came from neurosurgery, accounting for 29.6%, 49 cases from pediatric, accounting for 15.8%, 47 cases from ICU, accounting for 15.1%, 28 cases from orthopedic, accounting for 9.0%. Antimicrobial susceptibility test showed that MRSA had high sensitivity to vancomycin, linazolamide, tigarin, quinuprine/duphutin(>99%), and had different resistances to other antimicrobials. Conclusion Strong MRSA resistance, abuse of antibiotics, immune compromise, traumatic treatment are the risk factors for infection, so the clinical laboratory and clinical departments should strengthen the monitoring, rational use of antibiotics, reduce and control the production and propagation of MRSA strains.
Objective To analyze the infection and drug resistance of methicillin resistant Staphylococcus aureus(MRSA) in a hospital. Methods MRSA were collected from 2014 to 2017, and the clinical distribution, specimen type and drug susceptibility were analyzed. Results Among the 311 MRSA strains, 179 strains came from phlegm, accounting for 57.6%, 87 strains from secretions, accounting for 28.0%, 17 strains from blood, accounting for 5.5%. According to the distribution in clinical departments, 92 cases came from neurosurgery, accounting for 29.6%, 49 cases from pediatric, accounting for 15.8%, 47 cases from ICU, accounting for 15.1%, 28 cases from orthopedic, accounting for 9.0%. Antimicrobial susceptibility test showed that MRSA had high sensitivity to vancomycin, linazolamide, tigarin, quinuprine/duphutin(>99%), and had different resistances to other antimicrobials. Conclusion Strong MRSA resistance, abuse of antibiotics, immune compromise, traumatic treatment are the risk factors for infection, so the clinical laboratory and clinical departments should strengthen the monitoring, rational use of antibiotics, reduce and control the production and propagation of MRSA strains.
引文
[1] 胡付品, 朱德妹, 汪复, 等. 2014年CHINET中国细菌耐药性监测[J]. 中国感染与化疗杂志, 2015, 15(5): 401-410.
[2] 尚红, 王毓三, 申子瑜. 全国临床检验操作规程第4版[M]. 北京: 人民卫生出版社, 2015: 568-571.
[3] Siegel JD, Rhinehart E, Jackson M, et al. Management of multidrug-resistant organisms in health care settings[J]. Am J Infect Control, 2007, 35(10): 165-193.
[4] 禾葵向, 应永华. 耐甲氧西林金黄色葡萄球菌的药敏性变化分析[J]. 中华全科医学, 2016, 14(4): 635-638.
[5] 陈洋, 张文平, 马利军. 耐甲氧西林金黄色葡萄球菌研究进展[J]. 中华实用诊断与治疗, 2015, 29(12): 1145-1147.
[6] 陈子松, 李嘉, 周杭杰, 等. 新生儿血培养阳性病原菌分布及耐药状况分析[J]. 中国微生态学杂志, 2015, 27(6): 715-717.
[7] 胡秀梅. 2014-2016年院感金黄色葡萄球菌分布和药敏分析[J]. 中国预防医学杂志, 2018,19(5): 382-384.
[8] 汤金红, 江静静, 胡梅, 等. 医院多重耐药菌感染目标性监测与危险因素分析[J]. 蚌埠医学院学报, 2017, 42(11): 1540-1544.
[9] Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-Fourth Informational Supplement 2014[S]. Wayne, PA: CLSI, 2014.
[10] 周玖英, 陈孝进. 耐甲氧西林金黄色葡萄球菌耐药性监测与预防对策[J]. 检验医学与临床, 2008, 5(2): 95-96.
[11] 巴林其木格, 赵建平. 多重耐药球菌医院感染和耐药性研究进展[J]. 内蒙古医学杂志, 2017, 49(11): 1293-1296.
[12] 赵育新, 靳桂明, 司斌, 等. 合理使用抗生素质量标准评价与方法研究[J]. 中华医院感染学杂志, 1998, 8(3): 177-178.
[13] Longtin Y, SaxH, Allegranzi B, et al. Videos in clinical medicine, Hand hygiene[J]. N Engl J med, 2011, 364(13): e24.
[14] 徐晓莉, 黄慧敏, 尹湘毅, 等. 医院感染管理质量持续改进工作策略的研究[J]. 中华医院感染学杂志, 2014, 24(20): 5153-5155.
[15] 周小海, 吴劲松, 卢月梅, 等. 深圳市人民医院近五年临床分离金黄色葡萄球菌的分布及耐药性分析[J]. 中国微生态学杂志, 2018, 30(5): 556-559.
[2] 尚红, 王毓三, 申子瑜. 全国临床检验操作规程第4版[M]. 北京: 人民卫生出版社, 2015: 568-571.
[3] Siegel JD, Rhinehart E, Jackson M, et al. Management of multidrug-resistant organisms in health care settings[J]. Am J Infect Control, 2007, 35(10): 165-193.
[4] 禾葵向, 应永华. 耐甲氧西林金黄色葡萄球菌的药敏性变化分析[J]. 中华全科医学, 2016, 14(4): 635-638.
[5] 陈洋, 张文平, 马利军. 耐甲氧西林金黄色葡萄球菌研究进展[J]. 中华实用诊断与治疗, 2015, 29(12): 1145-1147.
[6] 陈子松, 李嘉, 周杭杰, 等. 新生儿血培养阳性病原菌分布及耐药状况分析[J]. 中国微生态学杂志, 2015, 27(6): 715-717.
[7] 胡秀梅. 2014-2016年院感金黄色葡萄球菌分布和药敏分析[J]. 中国预防医学杂志, 2018,19(5): 382-384.
[8] 汤金红, 江静静, 胡梅, 等. 医院多重耐药菌感染目标性监测与危险因素分析[J]. 蚌埠医学院学报, 2017, 42(11): 1540-1544.
[9] Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-Fourth Informational Supplement 2014[S]. Wayne, PA: CLSI, 2014.
[10] 周玖英, 陈孝进. 耐甲氧西林金黄色葡萄球菌耐药性监测与预防对策[J]. 检验医学与临床, 2008, 5(2): 95-96.
[11] 巴林其木格, 赵建平. 多重耐药球菌医院感染和耐药性研究进展[J]. 内蒙古医学杂志, 2017, 49(11): 1293-1296.
[12] 赵育新, 靳桂明, 司斌, 等. 合理使用抗生素质量标准评价与方法研究[J]. 中华医院感染学杂志, 1998, 8(3): 177-178.
[13] Longtin Y, SaxH, Allegranzi B, et al. Videos in clinical medicine, Hand hygiene[J]. N Engl J med, 2011, 364(13): e24.
[14] 徐晓莉, 黄慧敏, 尹湘毅, 等. 医院感染管理质量持续改进工作策略的研究[J]. 中华医院感染学杂志, 2014, 24(20): 5153-5155.
[15] 周小海, 吴劲松, 卢月梅, 等. 深圳市人民医院近五年临床分离金黄色葡萄球菌的分布及耐药性分析[J]. 中国微生态学杂志, 2018, 30(5): 556-559.