中文摘要：

目的研究PDCA循环法在耐甲氧西林金黄色葡萄球菌（MRSA）管理中的实施效果。方法回顾性分析2012年1月-2016年12月住院患者送检标本的细菌鉴定和药敏试验结果,Cox-Stuart趋势检验分析MRSA的检出率和耐药趋势。结果金黄色葡萄球菌中MRSA检出率为31.17%,经Cox-Stuart趋势检验分析,检出率呈下降趋势;MRSA对利奈唑胺、替加环素、替考拉宁、万古霉素、呋喃妥因、磺胺甲噁唑/甲氧苄啶、莫西沙星的耐药率〈30%,对青霉素、头孢西丁、苯唑西林、红霉素的耐药率〉75%;经Cox-Stuart趋势检验分析,MRSA对四环素、克林霉素、环丙沙星、庆大霉素、利福平、左氧氟沙星的耐药率呈下降趋势,而对头孢西丁、红霉素、苯唑西林、青霉素、莫西沙星、复方新诺明、呋喃妥因、万古霉素、利奈唑胺、替加环素、替考拉宁的耐药率无变化趋势。结论 PDCA循环法在MRSA管理中的实施效果良好,使得MRSA检出率和对克林霉素等抗菌药物的耐药率呈下降趋势。

英文摘要：

OBJECTIVE To observe the effect of PDCA cycle method on management of methicillin-resistant Staphylococcus aureus（MRSA）.METHODS The patients who were hospitalized from Jan 2012 to Dec 2016 were enrolled in the study,the submitted specimens were cultured,the drug susceptibility testing was performed for the isolated pathogens,and the isolation rate of MRSA and drug resistance trend were analyzed by means of Cox-Stuart trend test.RESULTS Among the S.aureus strains,the isolation rate of MRSA was 31.17% .The Cox-Stuart trend test indicated that the isolation rate showed a downward trend.The drug resistance rates of the MRSA strains to linezolid,tigecycline,vancomycin,nitrofurantoin,trimethoprim-sulfamethoxazole and moxifloxacin were less than30% ;the drug resistance rates to penicillin,cefoxitin,oxacillin and erythromycin were more than 75% .The CoxStuart trend test analysis showed that the drug resistance rates of the MRSA strains to tetracycline,clindamycin,ciprofloxacin,gentamycin,rifampicin and levofloxacin were decreased,however,the drug resistance rates to cefoxitin,erythromycin,oxacillin,penicillin,moxifloxacin,trimethoprim-sulfamethoxazole,nitrofurantoin,vancomycin,linezolid,tigecycline and teicoplanin did not change.CONCLUSION The PDCA cycle method can achieve significant effect on the management of MRSA and reduce the isolation rate of MRSA as well as the drug resistance rate to the antibiotics like clindamycin.