目的 分析耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及药敏试验,为临床合理使用抗生素及控制医院感染提供依据.方法 回顾性分析本院2013年1月至2015年12月分离的MRSA菌株,用WHO-NET 5.6软件分别按照科室分布、标本来源、年龄段及药物敏感性进行统计分析,用SPSS 17.0软件进行组间比较.结果 3年间共分离出金黄色葡萄球菌797株,其中MRSA 105株,分离率为13.2%.MRSA的标本来源以痰液、伤口分泌物、血液为主,分别占47.6%、27.6%、8.6%.临床科室分布以普外科、ICU、骨外科为主,分别占20.00%、14.30%、13.30%.MRSA对多种抗菌药物均呈不同程度的耐药性,对万古霉素、利奈唑胺全敏感.对苯唑西林、氨苄西林/舒巴坦、头孢唑啉、头孢呋辛、头孢西丁、庆大霉素、妥布霉素、左旋氧氟沙星、克林霉素、红霉素的耐药率均高于MSSA,差异有统计学意义(P<0.05).结论 MRSA的耐药形势十分严峻,应定期监测MRSA的临床分布及耐药性,并采取有效措施预防和控制医院感染的发生.
Objective To analyze the annual reporting to China Antimicroblal Resistance Survellance System data of our hospital in 2014, and to understand the distribution of hospital clinical isolates, specimen source, the distribution of drug resistance and multi-drug resistant pathogens.Methods Clinical isolates of pathogens distribution, specimen source, the distribution of multi-drug resistant and drug sensitivity test from software for January 2014 to December 2014 in our hospital were analyzed by WHONET 5.6 software, retrospectively.Results Among all the 4 779 isolated, Gram-negative bacteria accounted for 79.92% (3 819/4 779), and Gram-positive bacteria accounted for 20.08% (960/4 779). The top ifve bacteria wereEscherichia coli (1 477 strains, accounting for 30.91%),Klebsiella pneumoniae (677 strains, accounting for 14.17%),Pseudomonas aeruginosa (430 strains, accounting for 9% ),Acinetobacter (290 strains, accounting for 6.07%) andEnterococcus faecalis (270 strains, accounting for 5.65%). The top five clinical isolates of the department were pediatric (801 strains, accounting for 16.76%), general surgery (447 strains, accounting for 9.35%), urology (424 strains, accounting for 8.87%), respiratory medicine (341 strains, accounting for 7.14%) and critical care medicine (335 strains, accounting for 7.01%). The top ifve types specimens were respiratory specimens (1 824 strains, accounting for 38.17%), urine (1 050 strains, accounting for 21.97%), secretions (523 strains, accounting for 10.94%), drainage (513 strains, accounting for 10.73%) and blood (361 strains, accounting for 7.55%). Methicillin-resistant coagulase-negativeStaphylococci (53/148, 35.81%), producing extended spectrum β-lactamases (788/2 221, 35.48%), resistance to carbapenems BowmanAcinetobacter (9/52, 17.31%), methicillin-resistantStaphylococcus aureus (29/205, 14.15%),Enterobacteriaceae resistant to carbapenem 15 (15/2 712, 0.55%) were isolated, while penicillin-resistantStreptococcus pneumoniae unseparated to vancomycin-resistantEnterococci(VRE) and penicillin resistantStreptococcus pneumonia (PRSP) were not found.Conclusions The 2014 annual drug monitoring data analysis, on the distribution of hospital clinical isolates, specimen source, multi-drug-resistant and drug-resistant bacteria could guide clinical rational use of antibiotics in clinical to improve the security.
目的分析该院2011年泌尿生殖道解脲脲支原体(Uu)感染状况和耐药性,指导临床医生合理使用抗生素。方法收集1346例非淋菌性尿道炎患者应用法国生物-梅里埃公司提供的IST2试剂盒检测支原体耐药谱。结果 1346份标本培养阳性244份,阳性率18.1%,对支原体敏感的药物有多西环素、普那霉素、四环素、阿奇霉素等。结论 Uu是常见的泌尿生殖道感染病原菌,药敏试验可用于筛选敏感药物,以便指导临床医生合理使用抗生素。
