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医院内感染的发生率越来越高,分离菌株以高度耐药菌为主,耐甲氧西林金黄色葡萄球菌在院内感染中的比例越来越大,近年呈现迅速上升趋势。耐甲氧西林金黄色葡萄球菌耐药机制主要包括固有耐药(染色体介导)、获得性耐药(质粒介导)及基因表达调控、主动外排系统。随着万古霉素的广泛应用,耐万古霉素的金黄色葡萄球菌势必增多,临床上已陆续研发出头孢菌素类、碳青酶烯类、喹诺酮类、氨基糖苷类、恶唑烷酮类等新型治疗耐甲氧西林金黄色葡萄球菌的药物。耐甲氧西林金黄色葡萄球菌的多重耐药使治疗非常棘手,因此加强对耐甲氧西林金黄色葡萄球菌的传播控制,从患者-医护人员-患者的途径着手,加强培训,提高认识,严格消毒隔离制度,可以起到事半功倍的效果。
The incidence of nosocomial infections is getting higher and higher. The isolates are mainly resistant to highly resistant bacteria. The proportion of methicillin-resistant Staphylococcus aureus is increasing in the nosocomial infection and has been increasing rapidly in recent years. The mechanisms of resistance to methicillin-resistant Staphylococcus aureus include intrinsic drug resistance (chromosome-mediated), acquired drug resistance (plasmid-mediated) and gene expression regulation, active efflux system. With the widespread use of vancomycin, vancomycin-resistant Staphylococcus aureus is bound to increase cephalosporins, carbapenems, quinolones, aminoglycosides, oxazolidinones And other new treatment of methicillin-resistant Staphylococcus aureus drugs. The multi-drug resistance of methicillin-resistant Staphylococcus aureus makes treatment very difficult and therefore strengthens the transmission control of methicillin-resistant Staphylococcus aureus, starting with patient-caregiver-patient approach, strengthening training, raising awareness and rigorously Disinfection isolation system, can play a multiplier effect.