老年医院获得性耐甲氧西林金黄色葡萄球菌肺炎临床分析

目的了解和探讨老年患者医院获得性耐甲氧西林金黄色葡萄球菌肺炎(HAP-MRSA)的临床特点及药敏情况。方法回顾性分析2010年1月至2011年12月老年病房中48例年龄≥65岁老年医院HAP-MRSA患者的临床资料,包括一般情况、临床症状及体征、X线检查、实验室检查结果、药敏分析及病情转归。结果 48例HAP-MRSA患者中,治愈38例(79%),治疗终点死亡10例(21%),培养出的MRSA对所有β内酰胺类抗生素均耐药,而常见的敏感抗菌药物依次为:利奈唑胺、万古霉素、呋喃妥因等。结论对于老年HAP-MRSA,临床可选用利奈唑胺、万古霉素。

Clinical analysis of elderly patients with hospital acquired pneumonia caused by methicillin-resistant staphylococcus aureus

Objective To explore the clinical features of hospital acquired pneumonia （HAP） caused by Methi-cillin-resistant Staphylococcus aureus（MRSA） and the sensitivity to antibiotics. Methods The clinical data of 48 el-derly patients with HAP caused by MRSA from January 2010 to December 2011 were analyzed retrospectively, in-cluding the general condition, clinical symptoms and signs, X-ray findings, laboratory test results, drug sensitivity and prognosis. Results In the 48 cases of HAP-MRSA, 38 cases （79%） were cured, 10 cases （21%） died at end of ther-apy. MRSA are resistant to all 13-1actam antibiotics and the common sensitive antibiotics were respectively as the fol-lowings： linezolid, vancomycin, nitrofurantoinetc. Conclusion Linezolid or vancomycin can be used for the elderly patients with HAP-MRSA.