台灣醫學中心及區域醫院2001年－2003年金黃色葡萄球菌之抗藥性情形

Antimicrobial Resistance of Staphylococcus aureus from Medical Centers and Regional Hospitals in Taiwan: 2001-2003

王宗曦(Tsung-Hsi Wang) ； 張上淳(Shan-Chwen Chang) ； 陳主慈(Chu-Tzu Chen) ； 楊采菱(Tsai-Ling Yang) ； 施秀(Hsiu Shih) ； 王華恭(Hwa-Kung Wang) ； 周志浩(Jih-Haw Chou) ； 暨疾病管制局院內感染資料分析小組(The Working Group for Analysis of Nosocomial Infecti)

《感染控制雜誌》 16卷1期 (2006/02) Pp. 1-8

https://doi.org/10.6526/ICJ.200602_16(1).0001

摘要

爲瞭解年來台灣醫學中心及區域醫院金黃色葡萄球菌菌株之抗藥性情形，因而利用疾病管制局所收集台灣17家醫學中心及69家區域醫院2001年至2003年臨分離菌株及院內感染菌株抗生素敏感性試驗結果之資料，截取其中金黃色葡萄球菌之數據匯整分析。結果醫學中心之金黃色葡萄球菌全部臨床分離菌株對oxacillin之抗藥性比例（卽methicillin-resistant Staphylococcus aureus; MRSA）在2001年、2002年、2003年分別爲63.9%、64.5%、63.8%，區域醫院則分別爲58.0%、56.1%、59.3%；院內感染金黃色葡萄球菌菌株中（僅9家醫學中心及41家區域醫院提供資料），醫學中心MRSA所佔比例三年中分別爲80.0%、84.5%、及81.1%，區域醫院則爲79.7%、74.5%及78.0%。不論是臨床分離菌株或院內感染菌株對於其他抗生素，除vancomycin和teicoplanin 100%有效，對fusidic acid僅10%以下之抗藥性外，大多數都有50%至90%之高抗藥性比例。綜合而言，在台灣不論是醫學中心或區域醫院的金黃色葡萄球菌都有很高的MRSA比例，對於大多數其他抗生素也都有很高的抗藥性比例，對臨床醫師或感控人員而言，在處理上是一個很大的挑戰。

關鍵字

金黃色葡萄球菌 ； 抗藥性 ； 醫學中心 ； 區域醫院

並列摘要

In order to understand the recent status of antimicrobial resistance of Staphylococcus aureus isolates in Taiwan, we collected and analyzed the antimicrobial susceptibility data of S. aureus from 17 medical centers and 69 regional hospitals in Taiwan during 2001-2003. Among all clinical isolates of S. aureus from medical centers, the methicillin resistance rate was 63.9%, 64.5%, and 63.8% in 2001, 2002, and 2003, respectively For regional hospitals, the methicillin resistance rate of all clinical isolates was 58.0% 56.1%, and 59.3% in 2001, 2002, and 2003, respectively. In nosocomial strains, the methicillin resistance rate in these three years was 80%, 84.5%, and 81.1% for medical centers and 79.7%, 74.5%, and 78.0% for regional hospitals. Regardless of the strains were from all clinical isolates combined or from those causing nosocomial infections, S aureus isolates from both medical centers and regional hospitals had high rates of resistance (usually 50%-90%) to other antimicrobial agents except vancomycin, tesisoplanin, and fusidic acid. Rate of resistance to fusidic acid was less than 10% and almost all isolates were susceptible to vancomycin and teicoplanin. In summary, S. aureus isolates from medical centers and regional hospitals in Taiwan had high rates of resistance to methicillin and many other antimicrobial agents. Such high rates of antimicrobial resistance pose a big challenge to the medical personnel not only in treatment of patients but also in infection control.

並列關鍵字

Staphylococcus aureus ； antimicrobial resistance ； medical center ； regional hospital