慢性鼻窦炎耐甲氧西林葡萄球菌对抗生素的耐药分析

山东大学耳鼻喉眼学报

慢性鼻窦炎耐甲氧西林葡萄球菌对抗生素的耐药分析

陈俊¹,傅爱清¹,朱秋萍¹,楼正才²

义乌市中心医院 1. 检验科； 2. 耳鼻喉科，浙江义乌 322000

收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-04-24 发布日期:2007-04-24
通讯作者: 陈俊

Resistance of methicillin-resistant staphylococcus to antibiotics for chronic nasosinusitis

CHEN Jun¹, FU Ai-qing¹, ZHU Qiu-ping¹, LOU Zheng-cai²

1. Department of Clinical Laboratory; 2. Department of Otolaryngology, Yiwu Central Hospital，Yiwu 322000, Zhejiang, China

Received:1900-01-01 Revised:1900-01-01 Online:2007-04-24 Published:2007-04-24
Contact: CHEN Jun

摘要/Abstract

摘要： 目的：了解慢性鼻窦炎耐甲氧西林葡萄球菌(methicillin-resistant staphylococcus， MRS)的感染情况及耐药特点，为临床合理选用抗菌药物、有效控制MRS的感染提供依据。方法：　采用苯唑青霉素纸片法和琼脂筛选法，对临床分离的葡萄球菌行MRS检测，并测定了它们对20种常用抗生素的耐药谱和β-内酰胺酶。结果：　72株金黄色葡萄球菌中，耐甲氧西林株占37.6%，其中产β-内酰胺酶菌株占77.8%。凝固酶阴性的葡萄球菌(CoN葡菌)中，耐甲氧西林株占38.3%，其中产β-内酰胺酶菌株占72.7%。MRS菌株耐药程度明显高于甲氧西林敏感葡萄球菌（P<0.05）。金黄色葡萄球菌耐甲氧西林株和凝固酶阴性葡萄球菌耐甲氧西林株多重耐药数分别为6～17种和5～15种。结论：万古霉素、利福平、丁胺卡那对MRS显示了较强的抗菌活性。万古霉素是治疗感染的首选药物，MRS的多重耐药性应引起广泛关注，需加强抗生素使用的管理和MRS对抗生素耐药性的监测。

关键词: 鼻窦炎, 甲氧西林耐药, 葡萄球菌属, 抗生素类

Abstract: To investigate the infective rate of methicillin-resistant staphylococcus(MRS) and its resistance characteristics so as to provide a basis for the clinically rational use of anti-microbial agents and an effective control of MRS infections. Methods:　Strains of staphylococcus from clinical samples were determined by a disc agar diffusion method and MRS agar plate screening. At the same time their resistance to 20 different anti-microbial agents and the presence of β-lactamase in the strains were determined. Results： Twenty-seven strains of MRSA and thirty-three strains of MRSCoN were identified. The proportion of MRSA and MRSCoN was 37.6% and 38.3%, respectively. The incidence of MRSA and MRSCoN producing βlactamase was 77.8% and 72.7% ,respectively. The resistance rate showed a significant difference between the MRS and the MSS(P<0.05).The multi-resistance ranged from 6 to 17 and 5 to 15 antibiotics in MRSA and MRSCoN. Conclusions: Vancomycin, Rifampin and Amikacin have effective antibacterial activity against MRS. Vancomycin is the first choice for MRS infections. Wide attention should be paid to the multi-resistance of MRS, and the use of antibiotics should be better managed and the resistance of MRS to antibiotics should be further monitored.

Key words: Chronic nasosinusitis, Methicillin resistance, 　Staphylococcus, Antibiotics

中图分类号:

R765.23

陈俊,傅爱清,朱秋萍,楼正才 . 慢性鼻窦炎耐甲氧西林葡萄球菌对抗生素的耐药分析[J]. 山东大学耳鼻喉眼学报, 2007, 21(2): 130-132 .

CHEN Jun, FU Ai-qing,ZHU Qiu-ping, LOU Zheng-cai . Resistance of methicillin-resistant staphylococcus to antibiotics for chronic nasosinusitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(2): 130-132 .

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