【摘要】 [目的]了解耐甲氧西林金黄色葡萄球菌(MRSA)在医院内的流行及耐药特征,为预防和控制MRSA引起的院内感染提供科学依据。[方法]以上海某区一家综合性二级医院临床患者标本中分离的78株金黄色葡萄球菌(SA)和同时期该医院诊疗环境中分离的53株SA共131株SA为研究对象,分别用头孢西丁药敏纸片法和PCR法检测MRSA,K-B法检测该131株SA对15种抗菌药物的敏感性。[结果]131株SA中,MRSA构成比为55.73%(73/131)。其中,临床分离株和环境分离株中的MRSA构成比分别为52.56%(41/78)和60.38%(32/53),两者相比差异无统计学意义(P>0.05)。临床MRSA株主要分布于痰液及伤口分泌物;环境MRSA株主要分布于床头柜、监护仪以及医护人员手。抗菌药物敏感性实验显示,MRSA对-内酰胺类药物耐药率100%,对糖肽类药物、利奈唑胺、利福平高度敏感,对其他抗菌药物均呈多重耐药。[结论]MRSA在医院内有较高流行度,而且呈多重耐药性。应加强抗生素的合理使用,及时进行MRSA院内感染目标性监测,切实做好MRSA感染患者的消毒隔离工作。更多还原

【Abstract】 [Objective]To investigate the prevalence and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus(MRSA) in hospital,and to provide scientific basis for the prevention and control of MRSA nosocomial infection.[Methods]Totally 78 strains of Staphylococcus aureus(SA) were isolated from various clinical specimens and 53 strains of SA were isolated from hospital environment in the same time period in a secondary general hospital in Shanghai.MRSA was detected by cefoxitin disk diffusion test and polymerase chain reaction.The antimicrobial susceptibility of SA was tested by K-B disk diffusion test against 15 antibiotics agents.[Results]Among the 131 strains,the proportion of MRSA was 55.73%(73/131); the proportion of MRSA in the clinical strains and the environmental strains were 52.56% and 60.38% respectively(P>0.05).The clinical MRSA strains were mainly distributed in sputum and wound secretion,and the environmental MRSA strains were mainly distributed in bedside tables,patient monitors,and the hands of medical staff.The MRSA-to--lactam antibiotic resistance rate was 100%; all of the MRSA samples were highly sensitive to glycopeptide drugs,linezolid,rifampin,and showed multidrug resistance to other antibiotics.[Conclusion]MRSA is highly prevalent in hospital,and most MRSA strains are multi-drug resistant.Rational use of antibiotics and surveillance of MRSA nosocomial infection should be strengthened.Disinfection and quarantine for patients infected by MRSA should be performed in time.更多还原