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目的了解肿瘤患者耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及耐药性,指导临床合理选用抗菌药物。方法收集2015年临床送检的各类感染性标本,按常规方法进行分离培养,细菌鉴定采用法国生物梅里埃公司VTTEK-32微生物分析仪,药敏试验采用临床和实验室标准协会推荐的K-B法。结果共检出金黄色葡萄球菌26株,其中MRSA 11株(42.31%)。MRSA主要分离自痰液标本,其次是血液标本;科室来源主要为ICU,其次为肿瘤外科;共发生医院感染3例,其中血液系统2例,呼吸道1例。MRSA对夫西地酸、替考拉宁、万古霉素、喹奴普汀/达福普汀均敏感,对青霉素、苯唑西林均耐药。结论 MRSA是肿瘤患者医院感染的重要病原菌,临床分布广泛,且呈多药耐药性,应加强监测与控制,并合理使用抗菌药物,以减少MRSA菌株的产生与传播。
Objective To understand the clinical distribution and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in cancer patients and to guide the rational use of antibacterial drugs in clinic. Methods The infectious specimens collected in 2015 were collected and separated by conventional methods. The bacteria were identified by the VTTEK-32 microorganism analyzer from BioMerieux, France. The susceptibility test was performed using the KB method recommended by the Society of Clinical and Laboratory Standards . Results A total of 26 strains of Staphylococcus aureus were detected, of which 11 were MRSA (42.31%). MRSA was mainly isolated from sputum samples, followed by blood samples; the main source of the department was ICU, followed by oncology surgery; 3 cases of nosocomial infection occurred, including 2 cases of hematological system and 1 case of respiratory tract. MRSA fusidic acid, teicoplanin, vancomycin, quinudin / dalfopristin are sensitive to penicillin, oxacillin are resistant. Conclusions MRSA is an important pathogen of nosocomial infection in cancer patients. It has wide clinical distribution and multidrug resistance. It should be monitored and controlled intensively and antibacterials should be used rationally to reduce the production and spread of MRSA strains.