2018 年第 4 期 第 13 卷

金黄色葡萄球菌的菌株分离情况及耐药性分析

Distribution and drug resistance analysis of Staphylococcus aureus

作者：黄莎莎金炎范会李晓莹李平

英文作者：

单位：250021济南，山东大学附属省立医院医学检验部

英文单位：

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

英文关键词：

• 摘要：

• 目的    探讨山东大学附属省立医院金黄色葡萄球菌感染的菌株分布特征及耐药性。方法    对2016年1—12月山东大学附属省立医院金黄色葡萄球菌的检出情况进行分析，应用全自动微生物质谱检测系统进行致病菌鉴定，对菌株分离情况和检出科室分布以及标本来源进行分析；应用全自动微生物分析仪及GP67药敏卡进行药敏试验。结果    2016年1—12月山东大学附属省立医院临床共分离金黄色葡萄球菌512株，其中耐甲氧西林金黄色葡萄球菌160株，占31.2%;标本来源主要为痰液196株（38.3%）、分泌物176株（34.4%）、血液37株（7.2%）和脓液25株（4.9%）;临床检出科室主要为重症监护病房81株（15.8%）、皮肤科48株（9.4%）、呼吸科37株（7.2%）、胸外科28株（5.5%）;药敏试验显示金黄色葡萄球菌对青霉素、红霉素和克林霉素的耐药率分别为99.0%、75.6%和71.7%，对呋喃妥因的耐药率为0.4%，未发现对万古霉素、替加环素和利奈唑胺耐药菌株。结论    金黄色葡萄球菌的主要标本来源为下呼吸道、皮肤组织、伤口等部位，对临床常用抗菌药物的耐药现象较严重。在治疗金黄色葡萄球菌感染时，应根据药敏试验结果合理选择抗菌药物，以降低细菌耐药率。

• Objective    To investigate the distribution and drug resistance of Staphylococcus aureus（S.aureus） in Shandong Provincial Hospital Affiliated to Shandong University. Methods    S.aureus strains isolated from January to December 2016 in Shandong Provincial Hospital Affiliated to Shandong University were analyzed; automatic microbial mass spectrometry instrument was used in bacteria identification. Source and distribution of S.aureus were recorded; antimicrobial susceptibilities of common antibiotics were tested by automatic microbiological analyzer and GP67 drug sensitive test. Results   A total of 512 strains of S.aureus were isolated; 160 strains（31.2%） were methicillin-resistant S.aureus. S.aureus strains were mainly isolated from sputum［196（38.3%）］, secretion［176（34.4%）］, blood［37（7.2%）］ and pus［25（4.9%）］; main departments were intensive care unit［81（15.8%）］, dermatological department［48（9.4%）］, respiratory department［37（7.2%）］ and thoracic surgery department［28（5.5%）］. Drug resistance rates of S.aureus to penicillin, erythromycin, clindamycin and furadantin were 99.0%, 75.6%, 71.7% and 0.4%. No strain resistant to vancomycin, tegacycline and linezolid were observed. Conclusion    sMain specimen sources of S.aureus were lower respiratory tract, skin tissue, wound. Bacterial resistance rate of S.aureus is high in clinical practice.