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门诊皮肤科甲氧西林耐药和甲氧西林敏感金黄色葡萄球菌的流行趋势和抗生素敏感性模式。

Trends and antibiotic susceptibility patterns of methicillin-resistant and methicillin-sensitive Staphylococcus aureus in an outpatient dermatology facility.

机构信息

Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.

出版信息

JAMA Dermatol. 2013 Apr;149(4):427-32. doi: 10.1001/jamadermatol.2013.2424.

DOI:10.1001/jamadermatol.2013.2424
PMID:23325388
Abstract

OBJECTIVES

To determine whether the relative proportions of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) were changing or stable in an outpatient dermatology clinic and to examine the antibiotic susceptibility profiles of S aureus isolates.

DESIGN

Retrospective observational data were collected from skin culture isolates annually between January 1, 2005, and December 31, 2010, and monthly during the 6-month period of January 1, 2011, to June 30, 2011.

SETTING

The University of Miami Hospital outpatient dermatology clinic.

PARTICIPANTS

A total of 387 S aureus isolates were analyzed between January 1, 2005, and June 30, 2011, from adult and pediatric patients.

MAIN OUTCOME MEASURES

The relative proportions of MRSA and MSSA skin culture isolates were measured, along with antibiotic sensitivity profiles.

RESULTS

The overall relative proportion of MRSA was 35.7%. The overall relative proportion of MSSA was 64.3%. During the last 6 months of the study, the relative proportion of MRSA was 33.3%, while the relative proportion of MSSA was 66.7%. The relative proportion of MRSA from January 1, 2008, through December 31, 2010, was significantly higher than the relative proportion from January 1, 2005, through December 31, 2007 (45.3% vs 28.3%, P = .001). MRSA became more sensitive to ciprofloxacin, while MSSA became more resistant to ciprofloxacin, clindamycin, gentamicin sulfate, and trimethoprim-sulfamethoxazole.

CONCLUSIONS

The relative proportion of MRSA in the S aureus isolates increased by 17.0% during the last 3 years of our study. Despite this increase, MRSA became more sensitive to ciprofloxacin, while MSSA demonstrated increased antibiotic resistance to ciprofloxacin, clindamycin, gentamicin, and trimethoprim-sulfamethoxazole.

摘要

目的

确定在一家皮肤科门诊诊所中耐甲氧西林金黄色葡萄球菌(MRSA)和甲氧西林敏感金黄色葡萄球菌(MSSA)的相对比例是在变化还是稳定,并检查金黄色葡萄球菌分离株的抗生素敏感性谱。

设计

回顾性观察数据是从 2005 年 1 月 1 日至 2010 年 12 月 31 日每年从皮肤培养物分离株中收集的,并在 2011 年 1 月 1 日至 6 月 30 日的 6 个月期间每月收集。

地点

迈阿密大学医院皮肤科门诊。

参与者

分析了 2005 年 1 月 1 日至 2011 年 6 月 30 日期间从成人和儿科患者的 387 株金黄色葡萄球菌分离株。

主要观察指标

测量了 MRSA 和 MSSA 皮肤培养物分离株的相对比例以及抗生素敏感性谱。

结果

MRSA 的总体相对比例为 35.7%。MSSA 的总体相对比例为 64.3%。在研究的最后 6 个月中,MRSA 的相对比例为 33.3%,而 MSSA 的相对比例为 66.7%。2008 年 1 月 1 日至 2010 年 12 月 31 日期间 MRSA 的相对比例明显高于 2005 年 1 月 1 日至 2007 年 12 月 31 日期间的相对比例(45.3%对 28.3%,P =.001)。MRSA 对环丙沙星的敏感性增加,而 MSSA 对环丙沙星、克林霉素、硫酸庆大霉素和复方磺胺甲噁唑的耐药性增加。

结论

在我们研究的最后 3 年中,MRSA 在金黄色葡萄球菌分离株中的相对比例增加了 17.0%。尽管有这种增加,但 MRSA 对环丙沙星的敏感性增加,而 MSSA 对环丙沙星、克林霉素、庆大霉素和复方磺胺甲噁唑的抗生素耐药性增加。

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