【摘要】 目的了解医院呼吸内科ICU、急诊ICU和神经外科ICU感染葡萄球菌属的分布及耐药性,为ICU医院感染的预防与控制措施的制定提供理论依据。方法收集2006年7月-2008年7月医院呼吸科、急诊科和神经外科ICU患者的各种标本包括痰、血液、中段尿、分泌物、脓液分离的葡萄球菌属,对其分布、MRSA的检出以及药敏结果进行分析。结果共采集临床标本720例次,以痰标本居多,368例次,占51.11%;共分离葡萄球菌属171株,其中金黄色葡萄球菌居多,76株,占44.44%,表皮葡萄球菌次之,48株,占28.07%,76株金黄色葡萄球菌中,MRSA 44株,占57.89%,MSSA 32株占42.11%;MRSA对万古霉素和去甲万古霉素100.00%敏感外,对大部分抗菌药物耐药,对氯霉素和米诺环素的耐药率较低,均为20.45%;MSSA对抗菌药物的耐药率相对较低,对万古霉素和去甲万古霉素均100.00%敏感,其次是头孢唑林、阿米卡星和米诺环素,耐药率分别为6.25%、6.25%和10.00%。结论MRSA对临床常用抗菌药物耐药性较高,往往对几类抗菌药物同时耐药,一旦发现可疑病例即实施隔离,同时进行病原学的检查,强化手卫生,是预防与控制ICU内MRSA医院感染的重要措施。更多还原

【Abstract】 OBJECTIVE To investigate the resistance of Staphylococcus aureus,includ MRSA and MSSA,to antimicrobial agents in intensive care unit(ICU),and to provide basis for clinical therapy.METHODS K-B disk diffusion method was used to determine the drug susceptibility of 171 strains of S.aureus,and meticillin-resistant S.aureus(MRSA) was detected by using the disk diffusion method according to NCCLS/CLSI.RESULTS In ICU,S.aureus was isolated mostly from the respiratory tract,urine tract and blood.MRSA made up 57.89%.For MRSA and MSSA,no resistance against vancomycin and norvancomycin was observed.The resistance rates of MRSA to other agents were as follows: chloramphenicol 20.45%,and minocycline 20.45%.While the resistance rates of MSSA to other agents were as follows:cefazolin 6.25%,and amikacin 6.25%,minocycline 9.38%.CONCLUSIONS MRSA shows the multidrug resistance.Pathogenic monitoring,keeping the patients apart,rational utilization of antibiotics,medical facility sterilization strictly and intensive hand hygiene are very important to prevent MRSA infection.更多还原