社区获得性和医院获得性金黄色葡萄球菌感染比较
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吴永友

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R378.1+1

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苏州市科技发展计划指导项目(SZD09104)


A comparative study on community and healthcareassociated Staphylococcus aureus infection
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    摘要:

    目的比较社区获得性和医院获得性金黄色葡萄球菌的流行病学特征及对抗菌药物的耐药性,为临床诊疗提供依据。方法收集某院2008年1月—2010年1月临床和门诊的标本进行金黄色葡萄球菌的分离、鉴定和药敏试验,并收集感染者的流行病学资料进行分析。结果分别收集社区和医院获得性金黄色葡萄球菌140株和135株,两组中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率分别为22.86%(32/140)和50.37%(68/135),差异有统计学意义(χ2=22.482,P=0.000);标本来源部位,两组均以皮肤软组织和呼吸道为主,但构成比差异有统计学意义(χ2=79.741,P=0.000),社区获得性金黄色葡萄球菌的标本来源部位分布更为广泛。医院获得性金黄色葡萄球菌对氨苄西林、头孢西丁、四环素、庆大霉素、氯霉素、利福平、环丙沙星、亚胺培南的耐药率显著高于社区获得性金黄色葡萄球菌(均P<0.01)。结论社区获得性和医院获得性金黄色葡萄球菌在感染部位和对抗菌药物的耐药性等方面均有差异,临床应予重视;应及时送病原学检查和药敏试验,合理选择抗菌药物。同时应重视消毒隔离措施,避免金黄色葡萄球菌在家庭和医院中传播、扩散。

    Abstract:

    ObjectiveTo investigate the epidemiology and drug resistance of Staphylococcus aureus (S. aureus) from hospital and community, so as to provide reference for clinical diagnosis and treatment.MethodsThe isolation, identification and antimicrobial susceptibility testing of S. aureus from inpatients and outpatients from January 2008 to January 2010 were performed, epidemiological data of infected patients were studied.ResultsA total of 140 communityassociated(CA) and 135 healthcareassociated(HA) S. aureus isolates were collected, isolation rate of methicillinresistant Staphylococcus aureus (MRSA) in two groups was 22.86%(32/140)and 50.37%(68/135) respectively,the difference was significantly different (χ2=22.482,P=0.000); the main isolation sites of two groups were skin and soft tissue and respiratory tract, but constituent ratio was significantly different (χ2=79.741,P=0.000), CAS.aureus had more sources of isolation sites. HAS.aureus had higher resistant rate to ampicillin, cefoxitin, tetracycline, gentamicin, chloramphenicol, rifampicin, ciprofloxacin,and imipenem than that of CAS.aureus (all P<0.01).ConclusionCAS.aureus varied from HAS.aureus in infection sites and antimicrobial resistance, pathogenic detection and antimicrobial susceptibility testing should be performed timely, antimicrobial agents should be chosen rationally, and disinfection and isolation should be paid more attention, so as to avoid the transmission of S.aureus in family and hospital.

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张明霞,许铮,周惠琴,等.社区获得性和医院获得性金黄色葡萄球菌感染比较[J]. 中国感染控制杂志,2012,11(5):363-365.
ZHANG Mingxia, XU Zheng, ZHOU Huiqin, et al. A comparative study on community and healthcareassociated Staphylococcus aureus infection[J]. Chin J Infect Control, 2012,11(5):363-365.

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  • 收稿日期:2011-06-28
  • 最后修改日期:2011-09-23
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  • 在线发布日期: 2012-09-30
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