耐甲氧西林溶血葡萄球菌临床分离及耐药谱分析
临床分离的MRSH常表现为多重耐药，国外已有关于耐万古霉素的溶血葡萄球菌报道[7]，我院二年来末发现有耐万古霉素的溶血葡萄球菌，仅有l株MRSH中介。除β—内酰胺类、万古霉素外的106株MRSH对环丙沙星、氯洁霉素、红霉素、庆大霉素、四环素、复方新诺明6种抗菌药物耐药分析结果提示，至少对二种以上的抗菌药耐药，而以环丙沙星最高(90．6％)、四环素最低(30．2％)(表2)。环丙沙星作为氟哇诺酮类用于临床治疗的代表药，近年来MRSH对其的耐药性增长迅速，已基本失去疗效[8]；四环素作为一种较早用于临床的抗生素，由于近年来使用率不高，MRSH对其耐药性却相对较低，可见在选用何种抗生素作为治疗MRSH时，尽可能参照实验室所提供体外药敏试验结果，合理选择抗菌药物，提高临床治疗效果。
细菌的耐药谱常用于流行病学的同源性分析，从二年我院对106株MRSH的耐药谱分析提示，在分离菌株中共存在有19种不同源的MRSH。耐药谱中对四环素和复方新诺明或复方新诺明敏感，而对其他四种或五种抗生素耐药的模式最多43株(106株)，如不加以重视有导致由MRSH院内感染率上升，治疗效果下降。通过对MRSH的耐药谱分析有助于在经验治疗由MRSH引起的感染时。更合理的选择抗生素。
目前我国临床实验室中多半能对 MRSA进行监测，而对 CＮS中的 MRS，特别是MRSH的检测往往不够重视。MRS多种耐药基因在属内相互传递[9.10]，因此存在有同一性，用于检测MRSA的方法也适用于CNS中MRS检测，各级医院可依据本院的实际情况选用可与NCCLS推荐法相通的方法进行检测，了解其流行趋势，从而指导临床合理选用抗生素治疗MRS，并进而有效控制MRS在医院内感染。
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