905株葡萄球菌的种群分布及耐药性分析

目的了解某医院2010年临床分离葡萄球菌的种群分布和耐药性。方法对该院2010年临床分离的905株葡萄球菌的种群、耐药性做回顾性分析。结果905株葡萄球菌包含11个种，其中金黄色葡萄球菌（SAU）455株，占50．28％；凝固酶阴性葡萄球菌（CNS）450株，占49．72％；临床分离葡萄球菌对抗生素耐药率可因标本来源、培养环境、种群结构、产酶与否等因素差异有统计学意义。除利奈唑胺、万古霉素和呋喃妥因敏感及四环素耐药率差异无统计学意义以外，耐甲氧西林葡萄球菌（MRS）高于甲氧西林敏感葡萄球菌（MSS），x2值在4．30—451．0，P〈0．01或0．05，差异有统计学意义；β-内酰胺酶阳性菌高于β-内酰胺酶阴性菌，凝固酶阴性的葡萄球菌与凝固酶阳性菌对利福平、氨苄西林／舒巴坦、青霉素G、四环素、左氧氟沙星、庆大霉素的耐药率差异存在统计学意义，P〈0．05或P〈0．01；尿菌高于其他标本分离菌。各种葡萄球菌在各临床科室及标本中的分布也不尽相同。结论葡萄球菌耐药性可由多方面因素引起，临床实验室必须加强葡萄球菌分布和耐药性监测，为临床提供各种葡萄球菌诊治的依据。

Distribution and drug-resistance of 905 strains of staphylococci

Objective To analyze the strain distribution and drug-resistance of Staphylococci clinically isolated in a hospital in 2010.Method Retrospective analysis.Result There were 11 species in the 905 staphylococci,including 455(50.28%) Staphylococci aureus(SAU) and 450(49.72%) Coagulase-negative Staphylococcus(CNS).The drug-resistance of these staphylococci specimen varied significantly due to different specimen sources,culture conditions,strain structures,enzyme producing abilities,etc.There was no significant difference among the drug-resistance to Linezolid,Vancomycin and Nitrofurantoin-Tetracycline;The drug-resistance of methicillin resistant Staphylococcus aureus(MRSA) was greater than methicillin sensitive Staphylococcus aureus(MSSA)(χ2 value between 4.30-451.0,P<0.01 or 0.05),and the difference was significant or very significant.The drug-resistance of β-lactamase-positive was greater than β-lactamase-negative,and there were significant difference between the drug-resistance of β-lactamase-positive and β-lactamase-negative staphylococci to Rifampicin,Ampicilin/Sulbactam,Penicillin G,Tetracycline,Levofloxacin,and Gentamicin(P<0.05 or 0.01),respectively;The drug-resistance of urinary staphylococci was higher than those of the other specimens.The distribution of the staphylococci in different clinical departments and specimens were different.Conclusion The drug-resistance of staphylococci has many causes.Therefore,clinical laboratories must intensify monitoring of the distribution and drug-resistance of staphylococci,so as to provide bases for the diagnosis and treatment of various staphylococci.