青岛地区某医院肿瘤疾病组和非肿瘤疾病组 金黄色葡萄球菌耐药性的比较

Comparison of Staphylococcus aureus Resistance between Tumor Disease Group and Non-Tumor Disease Group in a Hospital in Qingdao

摘要: 目的：为了给临床有效防治金黄色葡萄球菌感染提供科学的用药依据，本研究针对肿瘤疾病与非肿瘤疾病相关的金黄色葡萄球菌耐药情况，开展了对比分析研究。方法：收集我院2019年1月至2024年12月期间，从各类临床标本中分离获取的非重复金黄色葡萄球菌菌株；整个研究过程执行参照卫生部医政司医院感染监测小组制定的诊断准则，将其划分为肿瘤疾病组与非肿瘤疾病组，对两组的耐药率开展卡方检验，同时针对其耐药特性及成因进行探析。结果：在非肿瘤疾病组的金黄色葡萄球菌中，该菌对万古霉素、克林霉素、利福平在内的6种抗生素的耐药率明显高于肿瘤疾病组；但红霉素的耐药率表现却恰好相反；两组之间青霉素类药物的耐药性无差别。2019年至2024年，两组疾病中金黄色葡萄球菌对红霉素与青霉素整体维持较高的抗药率，克林霉素、四环素和庆大霉素总体呈现下降态势，利福平的抗药率一直维持较低水平，环丙沙星的抗药率则呈现上升趋势，肿瘤疾病组中苯唑西林的抗药率也表现出上升趋势。结论：肿瘤疾病组的金黄色葡萄球菌对克林霉素、利福平、四环素、苯唑西林、庆大霉素及环丙沙星的耐药程度较非肿瘤疾病组感染低，耐甲氧西林葡萄球菌的检出占比也低于非肿瘤疾病组感染，该现象可能与两类患者的免疫情况、抗生素接触经历以及临床治疗策略存在不同有关。医院应建立联合管理机制，积极加强多部门协作，推行临床抗菌药的规范管理及合理使用，降低临床细菌耐药率，遏制多重耐药菌的增长。

Abstract: Objective: To provide a scientific basis for clinical management of Staphylococcus aureus (S. aureus) infections, this study conducted a comparative analysis of S. aureusresistance patterns between tumor-related and non-tumor-related diseases. Methods: Unique S. aureusstrains isolated from various clinical specimens in our hospital between January 2019 and December 2024 were classified into tumor and non-tumor disease groups per the diagnostic criteria established by the Hospital Infection Surveillance Team of the Medical Administration Department, Ministry of Health. Chi-square tests were used to compare resistance rates between groups, and resistance characteristics and underlying causes were explored. Results: In the non-tumor disease group, Staphylococcus aureus (S. aureus) displayed significantly higher resistance rates to six antibiotics, including vancomycin, clindamycin, and rifampicin, compared to the tumor disease group. Conversely, erythromycin resistance showed the opposite pattern. No significant difference in penicillin-class antibiotic resistance was observed between the two groups. From 2019 to 2024, S. aureusin both groups maintained relatively high overall resistance to erythromycin and penicillin-class antibiotics. Resistance to clindamycin, tetracycline, and gentamicin exhibited a downward trend; rifampicin resistance remained consistently low; ciprofloxacin resistance increased over time; and oxacillin resistance in the tumor disease group also showed an upward trend. Conclusion: Staphylococcus aureus in the tumor disease group exhibited lower resistance levels to clindamycin, rifampicin, tetracycline, oxacillin, gentamicin, and ciprofloxacin compared to the non-tumor disease group. Additionally, the detection rate of methicillin-resistant S. aureus (MRSA) was lower in the tumor group. This disparity may be attributed to differences in immune status, antibiotic exposure history, and clinical treatment strategies between the two patient populations. Hospitals should establish a joint management mechanism, strengthen multi-departmental collaboration, promote standardized management and rational use of clinical antimicrobials, reduce bacterial resistance rates, and curb the proliferation of multidrug-resistant bacteria.