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目的比较甲氧西林敏感金黄色葡萄球菌(Methicillin Sensitive Staphylococcus Aureus,MSSA)与耐甲氧西林金黄色葡萄球菌(Methicillin Resistant Staphylococcus Aureus,MRSA)的分布及耐药性,为临床经验治疗提供依据。方法回顾性分析2011-2015年门诊及住院患者分离的金黄色葡萄球菌及其临床资料。结果共分离出5 452株金黄色葡萄球菌,其中MSSA 2 554株(46.75%)、MRSA 2 898株(53.15%)。MSSA与MRSA阳性患者平均年龄分别为(29.81±30.68)岁及(52.86±26.85)岁。MSSA和MRSA标本来源前3位均为痰液(55.70%、85.30%)、分泌物(26.45%、5.87%)及脓液(5.46%、2.28%)。MSSA主要来源于门诊(21.15%)和儿呼吸科(12.19%),而MRSA主要来源于神经外科重症监护病房(28.81%)、神经外科(17.49%)及ICU(10.67%)。MSSA和MRSA对万古霉素和利奈唑胺100.00%敏感。MSSA对除青霉素G、氨苄西林和红霉素外的抗菌药物耐药率均<20.00%,而MRSA仅对万古霉素、利奈唑胺、呋喃妥因、利福平及复方新诺明敏感,耐药率<30.00%。结论临床分离的金黄色葡萄球菌以MRSA为主,MSSA和MRSA在年龄分布、标本来源、科室分布及耐药性方面存在较大差异。MRSA的耐药率明显高于MSSA,临床应根据不同菌株类型的耐药特点选用不同的治疗方案。
Objective To compare the distribution and drug resistance of Methicillin Sensitive Staphylococcus Aureus (MSSA) and Methicillin Resistant Staphylococcus Aureus (MRSA), and provide basis for clinical experience. Methods The clinical data of Staphylococcus aureus isolates from outpatients and inpatients from 2011 to 2015 were retrospectively analyzed. Results A total of 5 452 Staphylococcus aureus isolates were isolated, of which 5554 were MSSA (46.75%) and 898 (53.15%) were MRSA. The average age of MSSA and MRSA positive patients was (29.81 ± 30.68) years and (52.86 ± 26.85) years respectively. Sputum (55.70%, 85.30%), secretions (26.45%, 5.87%) and pus (5.46%, 2.28%) were the top three sources of MSSA and MRSA specimens, respectively. MSSA mainly came from outpatients (21.15%) and pediatric respiratory department (12.19%). MRSA mainly came from neurosurgical intensive care unit (28.81%), neurosurgery (17.49%) and ICU (10.67%). MSSA and MRSA are 100.00% sensitive to vancomycin and linezolid. MSSA resistant rates to antibiotics other than penicillin G, ampicillin and erythromycin were all <20.00%, whereas MRSA was sensitive to vancomycin, linezolid, nitrofurantoin, rifampicin, and cotrimoxazole alone Rate <30.00%. Conclusion The clinical isolates of Staphylococcus aureus are mainly MRSA. There are great differences in age distribution, specimen source, departmental distribution and drug resistance between MSSA and MRSA. MRSA drug resistance was significantly higher than the MSSA, clinical should be based on different strains of drug-resistant characteristics of the selection of different treatment options.