175 株金黄色葡萄球菌血流感染的临床分析

Clinical distribution and resistance of 175 strains of Staphylococcus aureus causing bloodstream infections

摘要:

目的 研究金黄色葡萄球菌（SAU）的感染特点及耐药性，为合理控制SAU 血流感染提供依据。 方法 血培养、细菌鉴定和药物敏感分析采用血培养仪及全自动细菌鉴定及药物敏感分析系统。采用χ2 检 验耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）对多种不同抗生素的耐 药率进行统计学分析。结果 175 例SAU 血流感染的患者中，因基础疾病引起者152 例，占86.9%，因肺部 感染引起者61 例，占34.9% ；SAU 对青霉素、阿奇霉素、红霉素、克拉霉素的耐药率均>90%，对利奈唑胺、 米诺环素和替考拉宁的耐药率均<10%，未发现耐万古霉素菌株。MRSA 对多种抗生素的耐药率大于MSSA。 结论 血流感染SAU 多继发于有严重基础疾病患者，其对多种抗生素的耐药率较高，但对利奈唑胺、米诺环素、 万古霉素仍保留较高敏感性。

Abstract:

Objective To investigate the infection status and drug resistance of 175 strains of Staphylococcus aureus (SA) in patients with bloodstream infections so as to provide basis for rational controlling such infections. Methods Blood culture, identification of the bacteria and drug sensitive test were conducted by BD blood culture instrument and full automatic BD microbe system. Chi-square test was used to analyze the drug resistance difference of Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-susceptible Staphylococcus aureus (MSSA). Results Among the 175 patients, bloodstream infections of 152 patients (86.9%) were caused by primary diseases, those of 61 patients (34.9%) were caused by pulmonary infection. The resistant rates of SA to Penicillin, Azithromycin, Erythrocin and Clarithromycin were all higher than 90%, while the resistant rates to Linezolid, Minocyline and Teicoplanin were lower than 10%, all the isolates were susceptible to Vancomycin. The resistant rates of MRSA to multiple antibiotics were higher than those of MSSA. Conclusions SA bloodstream infections are mostly caused by primary diseases. The resistant rates of SA to most antibiotics are high, but SA still keeps highly sensitive to Linezolid, Vancomycin and Minocyline.