临床分离耐甲氧西林葡萄球菌的耐药性监测

目的了解广东省湛江第二人民医院2004-2005年耐甲氧西林葡萄球菌（MRS）的分离情况，并分析其耐药性变化以及检测葡萄球菌中克林霉素诱导型耐药。方法使用BD公司的全自动细菌鉴定药敏系统（Phoenis^TM-100）及配套阳性菌药敏复合板同时进行菌株与药物敏感测定。用D-试验检测克林霉素诱导型耐药。结果该院耐甲氧西林葡萄球菌（MRS）的分离率较高；MRS对庆大霉素、环丙沙星、红霉素、克林霉素耐药严重，对氯霉素、利福平尚有较高的敏感度，对万古霉素、替考拉宁的敏感度最高。纸片扩散法诱导试验中，金葡萄中诱导耐药发生率较CNS高。结论MRS的分离检出率较高，其耐药性也不断增加，临床应重视病原菌的检测的药敏结果，合理用药。对于对克林霉素敏感的菌株，应加做D一试验以免造成错误判断导致临床治疗失败。

Monitoring about Drug Resistance of Methicillin-resistant Staph Which Separated from Clinical

Objective To understand the separation about MRS in the second people＇s hospital of Zhanjiang in 2004- 2005 and to analyze the drug resistance change, to detect the drug resistance about MRS which nduced by Clindamycin. Methods The strain and drug saitivity be determined by automatic identification of bacteria and drug sensitiveness system of BD corporation and corresponding drug sensitiveness composite board . The induce drug fast of Clindamycin be detect by D - trail. Results The isolating rate of MRS was high in hospital; MRS was very serious drug resistance to cidomycin , ciprofloxaein , erycin and Clindamycin, but it had high sensitiveness to alficetin and rifadin, it had the highest sensitiveness to vancocin and teicoplanin. The induce drug fast of MRS more higher than CNS in slip diffusion method. Conclusion The detection rate of MRS is high, drug resistance is constant increasing, The detection of pathogenic bacteria and drug sensitive outcome should be to think highly and reasonable select drug. The strain of sensitive to Clindamycin should do D - trail to avoid failure becase notcorrect judgement.