摘要
目的分析成人耐甲氧西林金黄色葡萄球菌(MRSA)感染的临床特征和耐药性,为临床感染控制和合理用药提供依据。方法回顾性分析2018年1—12月厦门市某三甲医院住院患者中137例成人金黄色葡萄球菌感染,按甲氧西林耐药性分为耐甲氧西林金黄色葡萄球菌的MRSA组和甲氧西林敏感的金黄色葡萄球菌(MSSA)的MSSA组,分析两组的临床资料和耐药性。结果MRSA组以外科系统、重症监护病房检出为主,送检标本以呼吸道标本居多(P=0.000);MRSA组合并神经系统疾病、侵入性操作、感染前抗生素使用情况(超过2种)、合并感染明显高于MSSA组;MRSA组病死率高于MSSA组(P均<0.05);合并神经系统疾病、实施侵入性操作是MRSA感染的独立危险因素;MRSA组对克林霉素、红霉素、环丙沙星、庆大霉素、利福平、妥布霉素、四环素、左氧氟沙星、美满霉素的耐药率明显高于MSSA组,差异有统计学意义(P均<0.05)。结论耐甲氧西林金黄色葡萄球菌感染病死率高;合并神经系统疾病、实施侵入性操作是MRSA感染的危险因素,MRSA菌株对多种抗生素耐药,临床应加强监测,根据药敏合理选择治疗药物。
Objective To analyze the clinical characteristics and drug resistance of methicillin-resistant Staphylococcus aureus(MRSA)infection in adults,and provide evidence for clinical infection control and rational drug use.Methods A total of 137 adult cases of Staphylococcus aureus infection among inpatients in a tertiary hospital in Xiamen from January to December 2018 were retrospectively analyzed.According to methicillin resistance,the patients were divided into the MRSA group of methicillin-resistant Staphylococcus aureus and the MSSA group of methicillin-sensitive Staphylococcus aureus(MSSA).The clinical data and drug resistance were analyzed in both groups.Results The MRSA group was mainly detected by the surgical system and intensive care unit,and most of the specimens submitted for examination were respiratory specimens(P=0.000);complicated neurological diseases,invasive procedures,pre-infection antibiotic usage(more than 2 types),and complicated infection in the MRSA group were significantly higher than those in the MSSA group(P<0.05 for all);the mortality rate in the MRSA group was higher than that in the MSSA group(P<0.05 for all);complicated neurological diseases and invasive procedures were independent risk factors for MRSA infection;the resistance rates to clindamycin,erythromycin,ciprofloxacin,gentamicin,rifampicin,tobramycin,tetracycline,levofloxacin,and minocycline in the MRSA group was significantly higher than those in the MSSA group,and the differences were statistically significant(P<0.05 for all).Conclusion The mortality of methicillin-resistant Staphylococcus aureus infection is high;complicated neurological diseases and invasive procedures are risk factors for MRSA infection.MRSA strains are resistant to a variety of antibiotics,and clinical surveillance should be strengthened,and therapeutic drugs should be selected based on drug sensitivity.
作者
谭艳
傅建国
岳蓓
TAN Yan;FU Jianguo;YUE Bei(Infectious Diseases Department,Zhongshan Hospital,Xiamen University,Xiamen Fujian 361004,China;Hospital-Acquired Infection Control Department,Zhongshan Hospital,Xiamen University,Xiamen Fujian 361004,China)
出处
《中国现代医生》
2021年第13期111-114,共4页
China Modern Doctor
关键词
耐甲氧西林金黄色葡萄球菌
临床特征
危险因素
耐药性
Methicillin-resistant Staphylococcus aureus(MRSA)
Clinical characteristics
Risk factors
Drug resistance
