NICU与综合性ICU感染金黄色葡萄球菌的耐药性对比分析

目的 比较新生儿重症监护病房（NICU）与综合性重症监护病房（ICU）金黄色葡萄球菌的耐药性，为临床合理选用抗菌药物提供依据。方法 对2011年6月-2015年7月NICU与综合性ICU患者临床标本中分离的金黄色葡萄球菌278株的耐药性比较，药敏试验采用纸片扩散法，采用WHONET 5.6和SPSS 20.0软件进行数据分析。结果 278株金黄色葡萄球菌对青霉素G、氨苄西林、美洛西林、头孢西丁等大部分抗菌药物的耐药率已较高，分别为100.00%、93.88%、80.94%、51.08%；综合性ICU感染金黄色葡萄球菌对克拉霉素、万古霉素、利奈唑胺、呋喃妥因等耐药率较低，分别为7.81%、0.00%、0.00%、0.00%；NICU与综合性ICU病房耐甲氧西林金黄色葡萄球菌（MRSA）检出率分别为34.88%和51.04%，NICU病房MRSA检出率低于ICU（P＜0.05）；头孢唑林及头孢噻肟在NICU与综合性ICU病房中的耐药率分别为19.77%，33.33%；13.95%，40.10%；NICU分离出的金黄色葡萄球菌对头孢唑林和头孢噻肟耐药率低于综合性ICU，差异有统计学意义（P＜0.05）；万古霉素及呋喃妥因在NICU与综合性ICU金黄色葡萄球菌中的耐药率分别为2.33%，0.00%；0.00%，0.00%；耐药率均较低（P＞0.05）。结论 临床选用抗菌药物应根据不同病区感染病原菌的耐药性和患者不同生理特点，本地区治疗NICU金黄色葡萄球菌感染可选头孢唑林和头孢噻肟，综合性ICU可选利奈唑胺和克拉霉素作为首选药。

Comparative analysis of drug resistances of Staphylococcus aureus in NICU vs ICU

Objective To compare the drug resistance of Staphylococcus aureus isolated from neonatal intensive care unit（NICU）and comprehensive intensive care unit（ICU）and provide basis for clinical rational use of antibacterial drugs．Methods The resistances of 278 strains of Staphylococcus aureus isolated from NICU and ICU patients during June 2011 and July 2015 were dectected with disc diffusion method．The resulting data were analyzed with WHONET 5.6 and SPSS20.0．Results The resistances of those Staphylococcus aureus strains to Penicillin G （100.00%），Ampicillin（93.88%），Mezlocillin（80.94%）and，Cefoxitin（51.08%）were high，while the resistances of the strains from ICU to Clarithromycin（7.81%），Linezolid（0.00%），Vancomycin（0.00%）and Nitrofurantoin（0.00%）were quite low．The detection rate of methicillin resistant Staphylococcus aureus（MRSA） in NICU vs ICU were 34.88% vs 51.04% respectively（P0.05）．Conclusion The clinical use of antimicrobial agents should be based on the resistance rates of pathogenic bacteria from different wards and physiological characteristics of patients. For treatment of Staphylococcus aureus infections in local hospitals，Cefazolin and Cefotaxime can be used as the options for NICU patients while linezolid，and clarithromycin for ICU patients．