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目的分析烧伤病房患者不同创面金葡菌的分布及耐药性,为临床合理选用抗菌药提供依据。方法对2006年1月至2013年12月间中国人民解放军第八五医院烧伤病房患者创面分离出金葡菌,采用K-B纸片扩散法进行药物敏感试验。分析金葡菌的耐药性,并对难愈性创面、非难愈性创面的耐甲氧西林金葡菌(MRSA)与甲氧西林敏感金葡菌(MSSA)的耐药性进行对比分析。结果分离出金葡菌112株,其中难愈性创面有70株MRSA和17株MSSA来自难愈性创面,16株MRSA和9株MSSA来自非难愈性创面。金葡菌对青霉素、红霉素、克林霉素的耐药率较高(分别为94.64%、81.25%和74.11%),对复方新诺明、呋喃妥因的耐药率较低(分别为16.07%和1.79%),对万古霉素、利奈唑烷的耐药率为0。MRSA的耐药率高于MSSA。来源于难愈性创面与非难愈性创面的MRSA仅在对利福平的耐药率上有明显差异,而来源于两创面的MSSA的耐药率无明显差异。结论创面金葡菌中MRSA的构成比高,难愈性创面MRSA耐药严重,应积极防控创面MRSA感染和扩散。
Objective To analyze the distribution and drug resistance of Staphylococcus aureus in different wounds in patients with burn ward and provide the basis for rational use of antibacterials in clinic. Methods Staphylococcus aureus was isolated from patients with burn wards in the 85th Hospital of Chinese People’s Liberation Army from January 2006 to December 2013, and K-B disk diffusion method was used for drug susceptibility testing. The drug resistance of Staphylococcus aureus was analyzed. The drug resistance of MRSA and methicillin-resistant Staphylococcus aureus (MSSA) were compared between refractory wounds and non-refractory wounds. Results Staphylococcus aureus was isolated in 112 strains, of which 70 MRSA and 17 MSSA were from refractory wound, 16 MRSA and 9 MSSA were from non-refractory wound. Staphylococcus aureus was more resistant to penicillin, erythromycin and clindamycin (94.64%, 81.25% and 74.11% respectively), and had a lower resistance to cotrimoxazole and nitrofurantoin (16.07 % And 1.79%, respectively. The rates of resistance to vancomycin and linezolid were zero. The rate of MRSA was higher than that of MSSA. MRSA derived from both refractory and non-refractory wounds showed significant differences only in the rate of resistance to rifampicin, whereas there was no significant difference in the rate of MRSA among the two wounds. Conclusion Staphylococcus aureus in wound composition of high ratio of MRSA, refractory wound MRSA resistance is serious, and should actively prevent infection and spread of wound MRSA.