CAJ | 학술논문

目的：了解我院2014年临床分离金黄色葡萄球菌的分布情况及耐药现状，为临床治疗相关感染提供依据。方法收集我院2014年全年临床各科室送检标本，采用法国BioMerieux VITEK2 Compact全自动细菌鉴定及药敏分析系统对菌株进行细菌鉴定和药物敏感性检测，并用Excel软件进行数据分析。结果2014年我院各种标本分离金黄色葡萄球菌共712株，标本分布主要以痰液(60.8%)为主，其次是脓液(17.8%)和分泌物(10.4%)；临床科室分布依次是儿科、呼吸內科和神经外科，分别占12.6%、10.8%和10.4%；MRSA菌株检出率为33.0%(235株/712株)，诱导克林霉素耐药菌株检出率为16.9%(120株/712株)。712株菌株对万古霉素，替加环素、奎奴普汀/达福普汀、利奈唑胺的耐药率最低，均为0%，对红霉素、克林霉素和四环素耐药率较高，分别是49.7%、48.0%和40.7%；MRSA菌株对红霉素、克林霉素、四环素、左氧氟沙星、环丙沙星、庆大霉素、莫西沙星和利福平的耐药率均比MSSA菌株高，且两者比较具有显著性差异(P<0.005)。结论我院临床分离金黄色葡萄球菌对红霉素、克林霉素和四环素的耐药性相对比较高，在临床经验用药方面应谨慎使用；另外MRSA菌株对抗菌药物的耐药性比较高，且呈多重耐药性，应加强监测控制，防止其流行传播。
목적：료해아원2014년림상분리금황색포도구균적분포정황급내약현상，위림상치료상관감염제공의거。방법수집아원2014년전년림상각과실송검표본，채용법국BioMerieux VITEK2 Compact전자동세균감정급약민분석계통대균주진행세균감정화약물민감성검측，병용Excel연건진행수거분석。결과2014년아원각충표본분리금황색포도구균공712주，표본분포주요이담액(60.8%)위주，기차시농액(17.8%)화분비물(10.4%)；림상과실분포의차시인과、호흡내과화신경외과，분별점12.6%、10.8%화10.4%；MRSA균주검출솔위33.0%(235주/712주)，유도극림매소내약균주검출솔위16.9%(120주/712주)。712주균주대만고매소，체가배소、규노보정/체복보정、리내서알적내약솔최저，균위0%，대홍매소、극림매소화사배소내약솔교고，분별시49.7%、48.0%화40.7%；MRSA균주대홍매소、극림매소、사배소、좌양불사성、배병사성、경대매소、막서사성화리복평적내약솔균비MSSA균주고，차량자비교구유현저성차이(P<0.005)。결론아원림상분리금황색포도구균대홍매소、극림매소화사배소적내약성상대비교고，재림상경험용약방면응근신사용；령외MRSA균주대항균약물적내약성비교고，차정다중내약성，응가강감측공제，방지기류행전파。
Objective To investigate the distribution and drug resistance of clinical strains of Staphylococcus aureus in our hospital in 2014 and provide the laboratory evidence for guiding antibiotic therapy. Methods Collecting specimens from clinical departments in our hospital from Jan 2014 to Dec 2014, bacterial identification and antibiotic susceptibility tests were performed by BioMerieux VITEK2 Compact, and the data were analyzed with Excel 2003. Results A total of 712 clinical strains of Staphylococcus aureus were isolated, Most of them were isolated from sputum(60.8%), pus (17.8%) and secretions(10.4%), those isolates were mainly isolated from paediatric department (12.6%), respiratory medicine (10.8%),neurosurgery department (10.4%). The detection rates of MRSA and inducible clindamycin resistance were 33.0%and 16.9%, respectively. The drug resistance rates of erythromycin (49.7%), clindamycin (48.0%) and tetracycline (40.7%) were higher than those of other antibiotics;those strains were sensitive to vancomycin, tigecycline, Quinupristin / Dafoe leptin and Linezolid. The drug resistance rates of MRSA against erythromycin, clindamycin, tetracycline, levofloxacin, ciprofloxacin gentamicin, moxifloxacin and rifampicin were significantly higher than those of MSSA (P<0.005). Conclusion Clinical isolates of Staphylococcus aureus in our hospital have relatively high drug resistance rates to erythromycin, clindamycin and tetracycline, MRSA strains were highly resistant to antimicrobial agents, and showed multiple drug resistance. Therefore, it is necessary to intensify the surveillance to prevent the prevalence and spread of MRSA.