201401425-肝炎患者葡萄球菌感染及耐药性分析7.docVIP

肝炎患者葡萄球菌感染及耐药性分析 余世敏1；胡东辉2 湖北省中山医院肝病科1、2，邮编：430033 摘要：【目的】分析肝炎患者葡萄球菌感染情况，从而了解感染者葡萄球菌分布特点和药敏实验结果，为针对性治疗提供参考依据。【方法】对2011年3月-2013年12月在我院接受中医治疗的病毒性肝炎住院患者，在其出现感染性疾病临床表现时，取痰液、血液、腹水、尿液等感染部位标本送检进行葡萄球菌分离培养。【结果】本次106例患者共检出147株葡萄球菌，金黄色葡萄球菌33株，占22.45；凝固酶阴性葡萄球菌114株，占77.55%。在金黄色葡萄球菌中，产酶菌株28株，产酶率为84.85%，凝固酶阴性葡萄球菌中产酶菌株有87株，产酶率为76.32%。金黄色葡萄球菌中MRSA发生率为6.06%。凝固酶阴性葡萄球菌中，MRCNS发生率为57.02%。在检出的金黄色葡萄球菌中，痰液检出比例最高占45.45%。金黄色葡萄球菌中，MSSA 仅对红霉素耐药率较高，达61.3%，而MRSA耐药情况较为严重，仅万古霉素及替拉考宁耐药率为0.0%，其余抗菌药均有不同程度耐药。凝固酶阴性葡萄球菌中，MSCNS对复方新诺明及红霉素耐药率较高。【结论】接受中医治疗的肝炎患者中，感染葡萄球菌的分布及耐药情况具有一定的特点，动态的监测致病菌分布并根据药敏实验结果针对性的治疗是控制患者感染的重要治疗手段。 关键词：葡萄球菌、病原谱、耐药性、肝炎 Analysis of Hepatitis staph infection and drug resistance Abstract: Objective: Staph infections in patients with hepatitis analysis, to understand the characteristics of the infected with staphylococcus distribution and drug susceptibility results, provide a reference basis for the specific therapy. Methods: From March 2011 - December 2013, hospitalized patients with viral hepatitis with clinical manifestations of infectious diseases were collected. The sputum specimens were collected, such as urine ascites positions are cultivation staphylococcus aureus. Methods: In 106 patients, 147 strains were staphylococcus aureus, 33 strains were staphylococcus aureus, accounting for 22.45%. 114 strains were coagulase negative staphylococcus aureus, accounting for 77.55%. In staphylococcus aureus, 28 were strains enzyme production strains, enzyme production rate was 84.85%, the middle enzyme coagulase negative staphylococcus strains have 87 strains, enzyme production rate was 76.32%. Incidence of MRSA was 6.06% in staphylococcus aureus coagulase negative staphylococcus. The incidence of MRCNS was 57.02% in the detection of staphylococcus aureus. Sputum had the highest percentage of 45.45% in staphylococcus aureus. MSSA had the erythromycin resistant rate is higher, accounting for at 61.3%. The drug resistance of MRSA situation is relatively serious, just for pu