2008-2010年医院葡萄球菌属的耐药性监测

目的 了解医院2008-2010年临床分离的葡萄球菌属对抗菌药物的耐药性.方法 收集医院2008-2010年临床分离的葡萄球菌属3315株,采用K-B法和CLSI 2008-2010年各年判断标准进行葡萄球菌属的耐药性监测；应用WHONET5.4及SPSSl9.0软件进行统计分析.结果 3315株葡萄球菌属临床分离株中金黄色葡萄球菌占49.0％、凝固酶阴性葡萄球菌(CNS)占51.0％；未发现万古霉素中介株和耐药株,葡萄球菌属对庆大霉素、头孢唑林、头孢呋辛、苯唑西林、左氧氟沙星、环丙沙星及利福平的耐药率总体呈上升趋势,且差异均有统计学意义(P＜0.05)；MRSA对红霉素、磺胺甲噁唑/甲氧苄啶的耐药率逐年上升,而对利福平的耐药率下降明显,差异均有统计学意义(P＜0.05)；MRSCN对氨基糖苷类、大环内酯类、喹诺酮类等药物的耐药率3年均有下降趋势,但对庆大霉素耐药率逐年增加(P=0)；儿童MRSA分离株对各种监测药物的耐药率均低于成人分离株,但对利福平的耐药率在2010年显著升高至71.9％.结论 葡萄球菌属耐药水平逐年增加,MRSA耐药仍然是目前临床上的严重问题,应加强临床葡萄球菌属的耐药性监测.

Surveillance of drug resistance of Staphylococcusfrom 2008 to 2010

OBJECTIVE To investigate the antibiotic resistance of clinical isolates of Staphylococcus from 2008 to 2010.METHODS A total of 3315 stains of Staphylococcus isolated during 2008-2010 were collected,Antimicrobial susceptibility was tested by Kirby-Bauer method and drug susceptibility tests were evaluated according to CLSI standards(2008-2010).WHONET5.4 and SPSSl9.0 software were used to analyze the data.RESULTS Of 3315 Staphylococcus strains,S.aureus accounted for 49.0%,coagulase-negative Staphylococcus accounted for 51.0%;no vancomycin-intermediate S.aureus or vancomycin-resistant S.aureus were found,the resistance rates of Staphylococcus to gentamicin,cefazolin,cefuroxime,oxacillin,levofloxacin,ciprofloxacin and rifampin exhibited as upward tendency,the differences were statistically significant(P<0.05);the resistance rates of MRSA to erythromycin and sulfamethoxazole/trimethoprim increased year by year,but the resistance rate to rifampicin decreased significantly,the difference was statistically significant(P<0.05);the resistance rates of MRSCN to aminoglycosides,macrolides,and quinolones declined in the three years,but the resistance rate to gentamicin increased year by year(P=0);the resistance rate of MRSA isolates from the children was lower than those from the adult to the tested antibiotics,but the resistance rate to rifampin significantly increased to 71.9% in 2010.CONCLUSION The drug resistance of Staphylococcus increases year by year,and the resistance of MRSA remains a serious clinical problem,it is necessary to strengthen the surveillance of the drug resistance of Staphylococcus.