社区获得性与医院获得性MRSA感染监测
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顾克菊

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R378.1+1 R969.3

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Surveillance on infections caused by communityassociated and healthcareassociated MRSA
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    摘要:

    目的了解社区获得性耐甲氧西林金黄色葡萄球菌 (CAMRSA)与医院获得性MRSA(HAMRSA)的耐药特征,为临床经验性选择抗菌药物提供参考依据。方法回顾性分析某院中医外科和重症监护室(ICU)2006年1月—2008年12月临床标本中分离的MRSA菌株资料,并对2个病区分离的CAMRSA 、HAMRSA及其耐药性进行统计分析。结果ICU分离的87株 MRSA来源:痰液71株,咽拭子6株,伤口分泌物 5株,血液、静脉穿刺管各2株,胸腔积液1株;其中HAMRSA占98.85%(86/87)。中医外科的41株MRSA均分离自伤口脓液,其中CAMRSA占48.78%(20/41),且有逐年上升趋势,由2006年的20.00%上升至2008年的71.43%(χ2=8.24,0.01< P<0.025)。药敏结果显示,HAMRSA 对克林霉素(98.13%)、四环素(98.13%)、红霉素(100.00%)、环丙沙星(100.00%)、左氧氟沙星(100.00%)、庆大霉素(100.00%)的耐药率显著高于CAMRSA(分别为42.86%、66.70%、33.33%、0.00%、0.00%、4.76%) ,两两比较,差异均有统计学意义(均P<0.005)。结论住院患者中CAMRSA感染呈上升趋势。CAMRSA 与HAMRSA的耐药性并不一致,对非β内酰胺类抗菌药物多敏感。

    Abstract:

    ObjectiveTo analyze the drug resistance of communityassociated methicillinresistant Staphylococcus aureus (CAMRSA) and healthcare associated MRSA(HAMRSA), so as to provide reference on empirical antimicrobial  therapy for treating MRSA infection. MethodsMRSA isolated from clinical specimens from surgical department and intensive care unit (ICU) in a hospital between January 2006 and December 2008 were analyzed retrospectively , distribution and drug resistance of CAMRSA and HAMRSA were analysed statistically.ResultsEightseven strains were from ICU , the sources were as follows: 71 strains were from sputum, 6 from throat swabs, 5 from wound secretion, 2 from blood and venipuncture tubes respectively, and 1 from pleural effusion; HAMRSA accounted for 98.85%(86/87). Fortyone MRSA strains from surgical department were all isolated from wound pus, CAMRSA accounted for 48.75%(20/41) , and showed an increasing tendency year by year, which increased from 20.00% in 2006 to 71.43% in 2008 (χ2=8.24, 0.01<P<0.025). Antimicrobial susceptibility test results showed that the resistant rates of  HAMRSA to clindamycin,tetracycline,erythromycin,ciprofloxacin,levofloxacin , and gentamycin was 98.13%,98.13%,100.00%, 100.00%,100.00% ,and 100.00% respectively, which was significantly higher than that of CAMRSA (which was 42.86%,66.70%,33.33%,0.00%,0.00% , and 4.76% respectively), there was significant difference between the two respectively(all P<0.005).ConclusionThere is an increasing tendency of CAMRSA infection in hospitalized patients , drug resistance of CAMRSA is different from that of HA MRSA , CAMRSA strains are usually susceptible to nonβlactam agents.

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顾克菊,王雪文,钟秀君,等.社区获得性与医院获得性MRSA感染监测[J]. 中国感染控制杂志,2011,10(2):136-138.
GU Keju, WANG Xuewen, ZHONG Xiujun, et al. Surveillance on infections caused by communityassociated and healthcareassociated MRSA[J]. Chin J Infect Control, 2011,10(2):136-138.

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  • 收稿日期:2009-03-09
  • 最后修改日期:2009-11-28
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  • 在线发布日期: 2011-03-30
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