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目的分析耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及耐药性,为临床合理用药及医院感染防控提供依据。方法回顾性分析本院2012年7月-2015年6月分离的MRSA株,用WHONET 5.6软件分别按照标本来源、科室分布及药物敏感性进行统计分析,用SPSS 17.0软件进行组间比较。结果本院3年间共分离出金黄色葡萄球菌366株,其中MRSA 120株,MRSA的分离率为32.8%。MRSA的标本来源以痰液、脓液、血液为主,分别占51.7%、30.8%、13.3%。临床科室分布以ICU、创伤外科、儿科为主,分别占25.0%、20.8%、14.2%。MRSA对多种抗菌药物均呈现不同程度的耐药性,对万古霉素、替加环素、利奈唑胺完全敏感。MRSA对苯唑西林、克林霉素、庆大霉素、四环素、左旋氧氟沙星、利福平、环丙沙星、莫西沙星、奎奴普丁/达福普汀、呋喃妥因的耐药率均高于MSSA,差异有统计学意义(P<0.05)。结论 MRSA的耐药形势十分严峻,应定期监测MRSA的临床分布及耐药性,并采取有效措施预防和控制医院感染的发生。
Objective To analyze the clinical distribution and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA), and to provide basis for clinical rational use of drugs and prevention and control of nosocomial infections. Methods The MRSA strains isolated from July 2012 to June 2015 in our hospital were retrospectively analyzed. The data were analyzed by WHONET 5.6 software according to the source of samples, the distribution of departments and the sensitivity of drugs. The data were compared with SPSS 17.0 software. Results A total of 366 Staphylococcus aureus isolates were isolated in our hospital in 3 years, including 120 strains of MRSA. The isolation rate of MRSA was 32.8%. The source of MRSA specimens were sputum, pus and blood, accounting for 51.7%, 30.8% and 13.3% respectively. The distribution of clinical departments to ICU, trauma surgery, pediatric mainly accounted for 25.0%, 20.8%, 14.2%. MRSA has a variety of antimicrobial agents showed varying degrees of resistance, to vancomycin, tigecycline, linezolid sensitive. MRSA resistance to oxacillin, clindamycin, gentamicin, tetracycline, levofloxacin, rifampicin, ciprofloxacin, moxifloxacin, quinuptin / dalfopristin, nitrofurantoin The drug rates were higher than MSSA, the difference was statistically significant (P <0.05). Conclusion The MRSA resistance situation is very serious. The clinical distribution and drug resistance of MRSA should be regularly monitored and effective measures should be taken to prevent and control the occurrence of nosocomial infections.