CAJ | 학술논문

目的：分析医院内与院外感染葡萄球菌的耐药性，为临床用药提供依据。方法收集2011年1月至2013年12月黄石市中心医院门诊（院外）、住院（院内）患者各种标本中分离的454株葡萄球菌，用VITEK‐32专用卡GPI及血浆凝固酶试验进行鉴定，药敏试验按K‐B琼脂扩散法进行，根据美国临床和实验室标准化协会2006对头孢西丁的耐药情况进行分类分析，数据分析用WHONET 5．5药敏分析软件。结果在379株金黄色葡萄球菌（SA）中，耐甲氧西林金黄色葡萄球菌（MRSA）检出率为41．2％，医院内、外标本 MRSA检出率分别为44．1％和19．6％，差异有统计学意义（ P＜0．05）；共检出凝固酶阴性葡萄球菌75株，医院内、外标本耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率分别为61．1％和38．1％，差异有统计学意义（P＜0．05）。未检出万古霉素、替考拉宁耐药菌株。结论耐甲氧西林葡萄球菌具有多重耐药性；院外SA感染者首选药物为庆大霉素、苯唑西林；若为院内SA和对于M RCNS引起的不论是院内或院外感染，均推荐首选万古霉素或替考拉宁。
목적：분석의원내여원외감염포도구균적내약성，위림상용약제공의거。방법수집2011년1월지2013년12월황석시중심의원문진（원외）、주원（원내）환자각충표본중분리적454주포도구균，용VITEK‐32전용잡GPI급혈장응고매시험진행감정，약민시험안K‐B경지확산법진행，근거미국림상화실험실표준화협회2006대두포서정적내약정황진행분류분석，수거분석용WHONET 5．5약민분석연건。결과재379주금황색포도구균（SA）중，내갑양서림금황색포도구균（MRSA）검출솔위41．2％，의원내、외표본 MRSA검출솔분별위44．1％화19．6％，차이유통계학의의（ P＜0．05）；공검출응고매음성포도구균75주，의원내、외표본내갑양서림응고매음성포도구균（MRCNS）검출솔분별위61．1％화38．1％，차이유통계학의의（P＜0．05）。미검출만고매소、체고랍저내약균주。결론내갑양서림포도구균구유다중내약성；원외SA감염자수선약물위경대매소、분서서림；약위원내SA화대우M RCNS인기적불론시원내혹원외감염，균추천수선만고매소혹체고랍저。
Objective To analyze the drug resistance of staphylococcus aureus (SA) in patients infected inside and outside hospitals in order to provide a basis for clinical drug use. Methods A total of 454 strains of staph were discreted from various kinds of examples of patients inside and outside hospitals in the hospital from Jan 2011 to Dec 2013, which were identified with GPI of VITEK‐32 system and plasma‐coagulase test, the disk diffusion method and classification analysis about drug fast of cefoxitin was performed according to guidelines of the CLSI (2006), WHO‐NET 5. 5 software was used to analyze the data. Results The detection rate of methicillin resistant staphylococcus aureus(MRSA) was 41. 2% of all 379 strains SA, which was 44. 1% and 19. 6% of samples inside and outside hospi‐tals, respectively, the difference was statistically significant (P<0. 05);in total, 75 strains coagulase negative staphy‐lococcus(CNS) were collected, the detection rate of methicillin resistant coagulase negative staphylococcus (MRCNS) was 61. 1% and 38. 1% of samples inside and outside hospitals, respectively, the difference was statistically signifi‐cant(P<0. 05). The drug resistant strain about vancomycin、teicoplanin wasn′t been detected. Conclusion MRS had multidrug resistance, the choice drug of patients infected outside hospitals by SA was gentamycin、oxacillin ;if hospital onset of infection of SA and hospital onset of infection or community infection of MRCNS, the choice drug was vanco‐mycin or teicoplanin.