|本期目录/Table of Contents|

[1]杨智芳,陈泽慧,陈安林,等.2012~2016年黔北地区某医院金黄色葡萄球菌临床分布与耐药性变迁[J].遵义医科大学学报,2019,42(05):561-565.
 Yang Zhifang,Chen Zehui,Chen Anlin,et al.Analysis of clinical distribution and drug resistance changes of Staphylococcus Aureus in hospital of north of Guizhou from 2012 to 2016[J].Journal of Zunyi Medical University,2019,42(05):561-565.
点击复制

2012~2016年黔北地区某医院金黄色葡萄球菌临床分布与耐药性变迁()
     
分享到:

《遵义医科大学学报》[ISSN:1000-9035/CN:22-1262/O4]

卷:
第42卷
期数:
2019年05期
页码:
561-565
栏目:
临床医学研究
出版日期:
2019-10-25

文章信息/Info

Title:
Analysis of clinical distribution and drug resistance changes of Staphylococcus Aureus in hospital of north of Guizhou from 2012 to 2016
文章编号:
1000-2715(2019)05-0561-05
作者:
杨智芳12陈泽慧1陈安林1周 婷1陈先恋1杨韦家3蔡 甜3
(1.遵义医科大学附属医院 医学检验科,贵州 遵义 563099; 2.遵义医科大学 研究生院,贵州 遵义 563099; 3.遵义医科大学,贵州 遵义 563099)
Author(s):
Yang Zhifang12Chen Zehui1Chen Anlin1Zhou Ting1Chen Xianlian1Yang Weijia3Cai Tian3
(1.Department of Medical Inspection Division,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China; 2.School of Graduate,Zunyi Medical University,Zunyi Guizhou 563099,China; 3.Zunyi Medical University,Zunyi Guizhou 563099,China)
关键词:
金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 抗菌药物 耐药性
Keywords:
staphylococcus aureus methicillin-resistant staphylococcus aureus antiseptic drugs drug resistance
分类号:
R378.1
DOI:
-
文献标志码:
B
摘要:
目的 了解黔北地区某医院金黄色葡萄球菌临床分布及耐药性变迁情况,为临床合理选用抗菌药物提供参考依据。方法 收集遵义医科大学附属医院2012~2016年从各种标本分离的33 458株菌,采用VITEK MS 质谱仪和VITEK-2 Compact全自动微生物鉴定分析仪对临床病原菌进行鉴定及药敏检测,应用WHONET 5.6统计软件对结果进行统计分析。结果 5年共分离金黄色葡萄球菌(S.aureus)3 278株,分离率从9.8%上升至23.9%; 耐甲氧西林金黄色葡萄球菌(MRSA)共分离1 156株,占总S.aureus 35.3%; 分泌物、痰液、脓液等为主要标本来源; S.aureus分布前5位科室分别是烧伤整形科、儿科、皮肤科、骨科和ICU; 药敏结果显示S.aureus对青霉素的耐药率>96%,红霉素>60%,四环素>40%,对庆大霉素、利福平、环丙沙星、左氧氟沙星、莫西沙星耐药率分别为33.9%~6.6%、21.2%~4.4%、28.8%~9.3%、28.8%~9.6%、18.9%~8.9%,对万古霉素和替加环素耐药率为0.0%。结论 S.aureus检出率逐年增加,对青霉素几乎全部耐药,对红霉素及四环素耐药率较高,而对庆大霉素、利福平、环丙沙星等耐药率呈现下降趋势,未发现对万古霉素及替加环素耐药的MRSA菌株; 加强临床科室细菌耐药性及多重耐药菌株的监测,对降低细菌耐药率有重要意义。
Abstract:
ObjectiveTo understand the clinical distribution and drug resistance of Staphylococcus aureus in hospital of north of Guizhou and provide experimental basis for rational selection of antibiotics in clinic.Methods A total of 33 458 strains of bacteria isolated from various specimens in the Affiliated Hospital of Zunyi Medical University from 2012 to 2016 was collected.The clinical pathogens were identified and tested by VITEK MS mass spectrometer and VITEK-2 Compact automatic microbial identification analyzer.Results were analyzed by WHONET 5.6 statistical software.Results A total of 3 278 strains of Staphylococcus aureus was isolated in 5 years,with the isolation rate rising from 9.8% to 23.9%.A total of 1 156 strains of methicillin-resistant Staphylococcus aureus(MRSA)was isolated,accounting for 35.3% of the total Staphylococcus aureus.Secrets,sputum and pus were the main sources of specimens.The top five departments of Staphylococcus aureus distribution were Burn Plastic,Pediatrics,Dermatology,Orthopaedics and ICU,respectively.Drug sensitivity results showed that Staphylococcus aureus had resistance to penicillin with resistance rate more than 96%,erythromycin with resistance rate more than 60%,tetracycline with resistance rate more than 40%,gentamicin,rifampicin,ciprofloxacin,levofloxacin and moxifloxacin with resistance rates from 33.9% to 6.6%,21.2% to 4.4%,28.8% to 9.3%,28.8% to 9.6% and 18.9 to 8.9%,respectively.The resistance rates to vancomycin and tegacycline were 0.Conclusion The detection rate of Staphylococcus aureus is increasing year by year.It is almost totally resistant to penicillin.The resistance rate of erythromycin and tetracycline is higher,while the resistance rate to gentamicin,rifampicin and ciprofloxacin showed a down ward trend.Vancomycin and tegacycline resistant MRSA strains are absent.To strengthen the monitoring of bacterial resistance and multi-drug resistant strains in clinical departments is necessary,which is of great significance for reducing the resistance rate of bacteria.

参考文献/References:

[1] 陈安林,陈泽慧,彭丹,等.2014~2016年黔北地区某医院肠杆菌科细菌临床分布与耐药变迁分析[J].遵义医学院学报,2018,41(1): 81-84. [2]Mcguinness W A,Malachowa N,Deleo F R.Vancomycin resistance in Staphylococcus aureus[J].Yale J Biol Med,2017,90(2): 269-281. [3]范陈良,李小四,吴晓燕.皮肤及软组织感染中金黄色葡萄球菌临床分布和耐药特性分析[J].中国抗生素杂志,2017,42(5): 413-417. [4]侯芳,吕媛.不容忽视的细菌耐药[J].中国抗生素杂志,2017,42(3): 203-206. [5]盛以泉,夏守慧,周芸,等.2011-2014年金黄色葡萄球菌分布与耐药变化趋势研究[J].中华医院感染学杂志,2016,26(1): 19-22. [6]Orlin I,Rokney A,Onn A,et al.Hospital clones of methicillin-resistant Staphylococcus aureus,are carried by medical students even before healthcare exposure[J].Antimicrob Resist & Infect Control,2017,6(1): 15-25. [7]郑惠琴,袁雪艳.抗菌药物在肺部感染住院患者中的用药研究[J].临床医药文献电子杂志,2016,3(50):10034. [8]肖玉玲,刘钰琪,杨扬,等.四川大学华西医院金黄色葡萄球菌临床分离株的分布及耐药变迁情况[J].中国循证医学杂志,2015,15(7): 781-785. [9]刘云,黄晓春,马炜,等.烧伤患者院内感染病原菌分布及耐药性分析[J].第二军医大学学报,2019,40(7):710-715. [10]Mcdanel J S,Perencevich E N,Diekema D J,et al.Comparative effectiveness of beta-lactams versus vancomycin for treatment of methicillin-Susceptible Staphylococcus aureus bloodstream infections among 122 hospitals[J].Clin Infect Dis,2015,61(3): 361-367. [11]Hassoun A,Linden P K,Friedman B.Incidence,prevalence,and management of MRSA bacteremia across patient populations-a review of recent developments in MRSA management and treatment[J].Critical Care,2017,21(1): 211. [12]沈林海,赵岚,谢利军,等.金黄色葡萄球菌耐药基因与耐消毒剂基因的检测与分析[J].中国消毒学杂志,2016,33(8):732-734. [13]刘明涛,李凯述,李超,等.万古霉素耐药折点调整对异质性万古霉素中介金黄色葡萄球菌筛选方法的影响[J].中国感染与化疗杂志,2016,16(4): 455-459.

相似文献/References:

[1]卢忠义(综述),宋 鸿(审校).金黄色葡萄球菌生物膜的研究进展[J].遵义医科大学学报,2012,35(05):464.

备注/Memo

备注/Memo:
[基金项目]贵州省卫生计生委资助项目(NO:gzwjkj2018-1-071); 遵义市科技局资助项目(NO:遵市科合HZ字[2019]87); 汇川区科技局资助项目(NO:遵汇科合[2017]15); 遵义医科大学第一临床学院资助项目(NO:2017053)。 [通信作者] 陈泽慧,女,教授,硕士生导师,研究方向:细菌耐药机制,E-mail:czhtyb@163.com。
更新日期/Last Update: 2019-10-25