CAJ | 학술논문

目的：了解医院分离的耐甲氧西林金黄色葡萄球菌（MRSA）的分布情况及耐药性特点，为临床合理使用抗生素提供理论依据。方法对2013年1月-2013年12月间临床标本中分离的86株 MRSA，采用 WalkAway 96 PLUS 型全自动细菌分析仪进行鉴定和药敏试验，应用 WHONET5.6软件对结果进行统计和分析。结果从临床标本中分离出的285株金黄色葡萄球菌中检出 MRSA 86株，检出率为30.18%；主要分布于各重症监护室（40.70%）、儿科病房（20.9%）及各外科病房（15.12%）；标本的主要来源为痰液和创面分泌物，所占比例分别为43.02%和34.88%。MRSA 对万古霉素、利奈唑胺及达托霉素的耐药率为0，对红霉素、克林霉素及四环素耐药率分87.2%、77.9%和74.4，对环丙沙星、庆大霉素的耐药率均大于50%。结论本院检出的 MRSA 具有高耐药和多重耐药的特点。医院应重视多重耐药菌株的监测，药敏结果的检测工作，对于指导临床合理用药、减少耐药株的产生及传播具有重要意义。
목적：료해의원분리적내갑양서림금황색포도구균（MRSA）적분포정황급내약성특점，위림상합리사용항생소제공이론의거。방법대2013년1월-2013년12월간림상표본중분리적86주 MRSA，채용 WalkAway 96 PLUS 형전자동세균분석의진행감정화약민시험，응용 WHONET5.6연건대결과진행통계화분석。결과종림상표본중분리출적285주금황색포도구균중검출 MRSA 86주，검출솔위30.18%；주요분포우각중증감호실（40.70%）、인과병방（20.9%）급각외과병방（15.12%）；표본적주요래원위담액화창면분비물，소점비례분별위43.02%화34.88%。MRSA 대만고매소、리내서알급체탁매소적내약솔위0，대홍매소、극림매소급사배소내약솔분87.2%、77.9%화74.4，대배병사성、경대매소적내약솔균대우50%。결론본원검출적 MRSA 구유고내약화다중내약적특점。의원응중시다중내약균주적감측，약민결과적검측공작，대우지도림상합리용약、감소내약주적산생급전파구유중요의의。
ObJective:To investigate the distribution and drug-resistance of methicillin-resistant Staphylococcus aureus (MRSA)separated in clinal so as to provide the basis for clinics to select antibiotics reasonably. Methods:Eighty-six strains of MRSA were isolated from January 2013 to December 2013. The identification and antimicrobial susceptibility tes-ting of the strains was performed by WalkAway 96 PLUS automatic bacterial identification system,and the test results were analyzed by WHONET5. 6 analytics software. Results:A total of 285 strains of S. aureus were isolated from clinical speci-mens,there were 86 strains of MRSA(30. 18% ),which mainly distributed in each ICU(40. 70% ),pediatric Wards (20. 9% )and various surgical wards(15. 12% );the sputum and wound secretions were the main specimens resources, accounting for 43. 02% and 34. 88% ,respectively. Drug-resistance of MRSA to vancomycin,linezolid and daptomycin were 0;to erythromycin,clindamycin and tetracycline were 87. 2% ,77. 9% and 74. 4;to ciprofloxacin,gentamicin resist-ance were all higher than 50% . Conclusion:MRSA detected in clinics have the characteristics of high resistance and multi-ple resistance. The hospital should pay attention to the monitoring of multiple drug-resistant strains and antimicrobial sus-ceptibility tests,which has profound significance for instructing application of the antibiotics reasonably and reducing the production and dissemination of resistant strains.