吴珍, 王莉洁, 喻航, 杜明梅, 梁志欣, 陈良安. 耐甲氧西林与甲氧西林敏感金黄色葡萄球菌血流感染的临床特征与耐药性分析[J]. 解放军医学院学报, 2016, 37(12): 1241-1244. DOI: 10.3969/j.issn.2095-5227.2016.12.006
引用本文: 吴珍, 王莉洁, 喻航, 杜明梅, 梁志欣, 陈良安. 耐甲氧西林与甲氧西林敏感金黄色葡萄球菌血流感染的临床特征与耐药性分析[J]. 解放军医学院学报, 2016, 37(12): 1241-1244. DOI: 10.3969/j.issn.2095-5227.2016.12.006
WU Zhen, WANG Lijie, YU Hang, DU Mingmei, LIANG Zhixin, CHEN Liang'an. Clinical characteristics of MRSA and MSSA bloodstream infection and their drug resistance[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2016, 37(12): 1241-1244. DOI: 10.3969/j.issn.2095-5227.2016.12.006
Citation: WU Zhen, WANG Lijie, YU Hang, DU Mingmei, LIANG Zhixin, CHEN Liang'an. Clinical characteristics of MRSA and MSSA bloodstream infection and their drug resistance[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2016, 37(12): 1241-1244. DOI: 10.3969/j.issn.2095-5227.2016.12.006

耐甲氧西林与甲氧西林敏感金黄色葡萄球菌血流感染的临床特征与耐药性分析

Clinical characteristics of MRSA and MSSA bloodstream infection and their drug resistance

  • 摘要: 目的 探究耐甲氧西林的金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA)和甲氧西林敏感的金黄色葡萄球菌(methicillin-sensitive Staphylococcus aureus,MSSA)血流感染的临床特征及药敏情况。 方法 收集解放军总医院2010年1月-2014年12月所有确诊为金黄色葡萄球菌血流感染的患者资料,分析耐甲氧西林金黄色葡萄球菌血流感染与甲氧西林敏感的金黄色葡萄球菌血流感染的临床特征与药敏之间的差异。 结果 共纳入183例患者,其中男性118例,女性65例;平均年龄(49.94±15.73)岁。金黄色葡萄球菌血流感染的致病菌以MRSA为主(59.6%),其中社区获得性金黄色葡萄球菌血流感染的致病菌50.8%仍为MRSA。MRSA和MSSA血流感染在性别、既往脑梗死病史、感染部位、住院期间手术史、感染性休克发生率、科室分布及死亡率等临床特征方面的差异有统计学意义(P< 0.05)。氨苄西林/舒巴坦,左氧氟沙星、利福平对MSSA的抗菌作用明显强于MRSA (P< 0.05)。 结论 金黄色葡萄球菌血流感染中MRSA占比较高,且MRSA和MSSA血流感染在临床特征及耐药性方面差异明显,在临床诊治上应区别对待。

     

    Abstract: Objective To investigate the clinical characteristics of bloodstream infection of methicillin resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) and their antimicrobial susceptibility test results. Methods From January 2010 to December 2014, clinical and microbial data of patients admitted to Chinese PLA General Hospital for Staphylococcus aureus bloodstream infection were collected. Chi-square test was perfomed to analyze the clinical characteristics and drug resistance between MRSA and MSSA bloodstream infection. Results One hundred and eighty-three patients were recruited, including 118 males and 65 females with average age of (49.94±15.73) years. MRSA accounted for 59.6% in all of Staphylococcus aureus infections. MRSA also accounted for 50.8% of all community-acquired Staphylococcus aureus bloodstream infection. There were significant differences in male/female ratio, history of cerebral infarction, infection site, history of recent surgery, morbidity of sepsis shock, admitted department and mortality between MRSA and MSSA bloodstream infection (P< 0.05). Ampicillin/sulbactam, levofloxacin, rifampin were more susceptible to MSSA than MRSA (P< 0.05). Conclusion MRSA plays an important role in Staphylococcus aureus bloodstream infection. The differences in clinical characteristics and drug-resistance between MRSA and MSSA bloodstream are significant, which are indicative for the diagnosis and treatment on Staphylococcus aureus bloodstream infection.

     

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