Conspicuous endoscopic appearance of ventriculitis caused by coagulase-negative staphylococci

To date, reports about the macroscopic appearance of ventriculitis have been rare, consisting only of a few autopsy cases. A patient in our hospital had ventriculitis caused by coagulase-negative staphylococci, and under neuroendoscopy we obtained clear findings of granular ependymitis. A 44-year-old man was admitted for disturbance of consciousness caused by progressive hydrocephalus. He had experienced subarachnoid hemorrhage (SAH) from a left vertebral dissecting aneurysm, and had subsequently received a ventriculoperitoneal shunt against post-SAH hydrocephalus. After admission, he was found to have retrograde shunt infection from peritonitis caused by cholecystitis. Coagulase-negative staphylococci were detected in cerebrospinal fluid (CSF), and the infection persisted even with intrathecal administration of gentamycin, and intravenous administration of vancomycin and arbekacin. Endoscopic rinsing was performed, and multiple small yellowish microgranulations, less than 1 mm in diameter, were observed in the lateral ventricles and the third ventricle. Rinsing of the CSF after intensive antimicrobial treatment resulted in a cure. Because there have been no reports of endoscopic observations of bacterial ventriculitis, we were unable to be certain about the origin or significance of the microgranulations. However, whether or not the microgranulations were bacterial colonies, infection did not recur during a 2-year follow-up period.     

First case of a bloodstream infection caused by the genus Brachybacterium

An 83-year-old previously self-sufficient man was referred to our hospital for a fever, severe tenderness over the lumbar spine, and elevated C-reactive protein levels. Computed tomography revealed fluid collection in the intervertebral space of L3/4. Gram-positive, short rod-shaped bacteria were isolated from two sets of blood cultures. A 16S rRNA sequence analysis of an isolate showed a similarity of 98.1% to the nearest type strain Brachybacterium squillarum JCM 16464^T. Biochemical characteristics of the presently isolated strain differed from those of the most closely related species of the genus Brachybacterium. The patient was successfully discharged on day 73 of admission with antimicrobial therapies and showed no recurrence during outpatient visits. Brachybacterium spp. have mainly been isolated from the environment, and human Brachybacterium infections have rarely been documented to date. To our knowledge, this is the first clinical isolation of Brachybacterium sp. as a causative pathogen of bloodstream infection.     

鲍曼不动杆菌血流感染临床分析

目的研究鲍曼不动杆菌血流感染患者的临床特征、感染危险因素及细菌耐药性。方法回顾性分析我院2001年1月至2006年12月间由鲍曼不动杆菌所致血流感染患者的临床及微生物学资料。结果21例患者入选，病死率33．3％。所有患者均有发热，发生血流感染时血白细胞计数平均14．5×10^9／L（4．77×10^9～36．01×10^9／L）。患者有手术史10例，中心静脉导管14例，气管插管或气管切开13例，原发感染灶不明10例（47．6％），继发于下呼吸道感染9例（42．9％），中心静脉插管来源的3例，其他感染灶包括外科伤口等2例。死亡组与存活组相比APACHEⅡ评分高，死亡组菌株耐药性高于存活组。结论鲍曼不动杆菌血流感染病死率高，且多为耐药菌株感染，应引起重视。     

汕头地区血流感染菌群调查及耐药性分析

目的了解汕头地区近两年血流感染患者的茼群分布及药敏特点。方法对2010至2011年汕头市澄海区人民医院和汕头市中心医院394株血培养阳性检出菌的菌群分布、药敏结果进行统计分析。结果送检血培养标本4171倒中阳性茼株394株,阳性率为9．45％。其中革兰阳性菌（C＋）164株（41．62％）,革兰阴性茼（G-）200株（50．76％）,真茼30株（7．61％）。其中凝固酶阴性萄萄球茼（CNS）居首位（24．87％）,其次为大肠埃希菌（20．05％）,肺炎克雷伯菌（9．14％）,金黄色葡萄球菌（6．35％）,鲍曼不动杆茼（4．57％）,沙门茼属（3．05％）,铜绿假单胞茼（2．79％）,屎肠球茼（2．54％）。CNS检出率最高的科室为新生儿／小儿科（49．05％）,其次为呼吸内科（3s．89％）,血液内科（19．35％）,ICU（18％）。耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）占81．67％。耐甲氧西林金黄色葡萄球菌（MRSA）占71．43％,产起广谱B内酰胺酶的大肠埃希菌（ESBk）占74．03％,尚未发现万古霉素耐筠的革兰阳性球菌。结论汕头地区血流感染中革兰隅性菌占优势,新生儿／小儿科的CN$居首位,耐药性病原菌检出率南,需要积极了解和监测致病菌株的耐药性,熟知抗生素的应用原则,加强临床与实验室的沟通,根据药教结果及时合理地调整用药。     

血培养凝固酶阴性葡萄球菌阳性的临床意义

目的 :评价血培养中凝固酶阴性葡萄球菌 (CNS)阳性的临床意义。方法 :对本院 1995～ 1999年血中分离到CNS的70例住院患者进行回顾性分析 ,判定是菌血症还是血样本污染。结果 :70例患者中 37例 (5 2 .9% )为菌血症 ,其入侵部位 15例 (4 0 .5 % )为静脉插管及人工装置 ,8例 (2 1.6 % )为术后伤口感染 ,4例为呼吸道 ,4例为脐带 ,1例为眼部 ,5例不明。 37例菌血症主要发生于重症监护病房、新生儿病房、外科病房和血液科病房。入院 48h内检出的CNS中 ,2 4株 (39.3% )为污染菌 ,入院 48h以后检出的CNS ,均为污染菌 (9株 ) ;污染菌的检出时间显著长于病原菌 (36 .2h/2 1.9h ,P =0 .0 1)。病原菌与污染菌对青霉素、苯唑西林、庆大霉素、环丙沙星、万古霉素的敏感性差异无显著性 (P >0 .2 5 )。在 15例由静脉插管及人工装置引起的菌血症中 ,10例经拔除导管后 ,菌血症得到控制 ;另 5例还同时使用了万古霉素 ,菌血症才得以控制。结论 :CNS血培养阳性时污染率较高 ,需综合临床和实验室的资料判定其临床意义 ,避免不必要地使用万古霉素等抗微生物药物     

碳青霉烯类耐药肺炎克雷伯菌致血流感染危险因素及预后分析

目的分析碳青酶烯类耐药肺炎克雷伯菌(CRKP)所致血流感染的临床危险因素和预后转归,为院感防控提供参考。方法回顾性分析河南省人民医院2017年7月—2019年7月281例肺炎克雷伯菌血流感染患者的临床资料,分析CRKP感染的危险因素及预后转归。结果281例肺炎克雷伯菌血流感染患者中CRKP感染124例,碳青霉烯类敏感肺炎克雷伯菌(CSKP)感染157例。CRKP血流感染患者死亡率及住院天数均高于CSKP血流感染患者(P<0.05)。行侵入性治疗、使用碳青霉烯类抗菌药物及酶抑制剂是CRKP感染的危险因素。CRKP感染预后较差。结论CRKP血流感染治愈率低,患者预后差。使用抗菌药物及行侵入性治疗可增加CRKP血流感染的风险。感染后经验用药合理仍然是其预后良好的保护性因素。     

An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes

IntroductionRalstonia insidiosa, a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes.Material and methodsThe present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To investigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed-field gel electrophoresis (PFGE) was used to perform molecular typing.ResultsSeventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa.ConclusionR. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.     

Extensive multidrug resistance of coagulase-negative staphylococci in medical students

Staphylococcus aureus and coagulase-negative staphylococci (CNS) isolated from the nasal mucosa of medical students were examined for susceptibility to 16 antimicrobial agents. No methicillin-resistant S. aureus (MRSA) was isolated, while MRCNS was present in 23.5% of the medical students. CNS exhibited significantly more resistance to antimicrobial agents such as gentamicin, in addition to oxacillin, compared to S. aureus, and 13.1% of the CNS strains (mostly MRCNS) were multidrug-resistant (to five or more drugs). In contrast, ampicillin resistance was higher in S. aureus. The rate of hospitalization or of taking an antimicrobial agent within the past 1 year was lower in CNS⁺ students than in S. aureus ⁺ students. The data suggest that CNS could serve as a reservoir of drug resistance by persistent colonization in the nasal mucosa. In this study, MRCNS with multidrug resistance was found in medical students. More attention should be given to nasal MRCNS in medical students as a possible spreader in hospitals.     

Invasive pectoral abscess and costal osteomyelitis with bloodstream infection caused by methicillin-resistant Staphylococcus aureus after nasal septoplasty in an immunocompetent adult patient

There are few reports of multilocus sequence type (ST) 5/staphylococcal cassette chromosome (SCC) mec type IVc/toxic shock syndrome toxin (TSST)-1- positive methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections.We report a case of community-onset MRSA (CO-MRSA) bloodstream infection in a healthy 41-year-old Japanese man after nasal septoplasty, followed by pectoral abscess and costal osteomyelitis. The patient presented with right anterior chest pain and fever. After admission, MRSA was isolated from two sets of blood cultures, and vancomycin was administered. On the fifth day, contrast-enhanced computed tomography (CT) scan and contrast-enhanced magnetic resonance imaging (MRI) scan showed an abscess in the right anterior chest to the right subpleural region. The dosage of vancomycin (4 g/day) did not reach the effective blood concentration; therefore, there was a switch to daptomycin. On the 23rd day, contrast-enhanced MRI revealed osteomyelitis of the right first rib, and as a result, linezolid was initiated. Two weeks later, contrast-enhanced CT of the chest showed improvement in the abscess. The patient was treated for 6 weeks during hospitalization and then switched to minocycline for 10 weeks.Molecular characterization of this isolate showed that it was ST5/SCCmec type IVc/TSST-1-positive/Panton-Valentine leucocidin (PVL)-negative.PVL-negative CO-MRSA can lead to hematogenous osteomyelitis and abscess even if the patient is immunocompetent, and if isolated from blood cultures, it is important to repeat imaging studies, even if the initial imaging studies were normal. It is possible that this strain contributes to the pathogenesis of invasive CO-MRSA, but further case accumulation is needed.     

导管保留法诊断导管相关性血流感染的研究

目的研究保留静脉导管时诊断导管相关性血流感染(CRBSI)的检验方法,为减少临床不必要的静脉导管拨除提供实验室诊断依据。方法从2009年11月起,华山医院中心重症监护室临床医生根据患者的临床表现将患者分为需要保留导管者和拔除导管者,保留导管者分别从外周静脉和中心静脉导管各抽血1套(1瓶厌氧培养和1瓶需氧培养)进行血培养,另外再分别抽取3 mL血进行血定量培养,必须拔除导管时,拔出导管并采集2套外周静脉血送检。结果 50例保留导管送检病例中,27例检出细菌生长,其中临床加实验室综合判定为CRBSI 10例,导管保留法正确判定8例,2例判定为定植;综合判定为定植者7例,导管保留法正确判定6例,1例阴性;1例污染。血定量培养仅见在加有中和剂的巧克力平板上有细菌生长。结论分别从外周和中心静脉抽血进行血培养和血定量培养能够可以准确检出CRBSI及导管细菌定植。     

阴沟肠杆菌血流感染52例临床分析

目的调查分析阴沟肠杆菌血流感染的临床特点、耐药情况、危险因素以及目前我院流行病学等特点。方法调查从2000—2005年5月血培养阴沟肠杆菌阳性的病例,回顾性调查相关的病史资料和实验室数据。结果共纳入52例,其中25例是泌尿外科患者。医院感染共有45例。6例患者为原发感染。1株细菌对亚胺培南-西司他丁耐药,30株对头孢曲松、头孢噻肟、头孢他啶和头孢吡肟耐药。7例患者因血流感染死亡。结论阴沟肠杆菌血流感染相对少见,但其发生率呈上升趋势;我院以泌尿外科患者最多见,泌尿外科手术和导尿管的放置是主要危险因素。其他还有肾移植、糖皮质激素或细胞毒性药物的应用以及广谱抗生素应用等。头孢菌素类的应用是产生耐药性的重要危险因素之一。阴沟肠杆菌对抗菌药物多呈多重耐药性,尤其对广谱头孢菌素耐药率高。经恰当的抗感染治疗,多数患者可获生存。     

血清降钙素原水平在血流感染中的临床价值

目的探讨血清降钙素原(PCT)水平在血流感染患者中的临床价值。方法回顾性分析我院568例同时送检PCT检测和血培养的结果,其中有效研究对象538例;比较PCT水平与血培养结果的关系,同时比较PCT在革兰阴性菌、革兰阳性菌及真菌之间的差异;选取多次行PCT检测的血培养阳性患者,并依据3周内转归分为好转组、迁延组及死亡组,比较不同转归患者PCT差异。各组间PCT差异比较采用秩和检验;预后分析中采用Fisher’s精确概率法。结果血培养阳性患者PCT值[3.39(0.69~6.52)μg/L]明显高于血培养阴性患者[0.31(0.09~1.48)μg/L],差异有统计学意义(P0.05);G-菌、G+菌及真菌感染患者PCT分别为4.39(1.80~10.85)μg/L、1.98(0.42~4.05)μg/L及0.62(0.39~3.98)μg/L,差异有统计学意义(P0.05);根据受试者工作特征曲线(ROC),PCT临界值设定为3.315μg/L时,区分G-菌与真菌血流感染的灵敏度为67.9%,特异度为75.0%;设定为4.1μg/L时,PCT区分G+菌与G-菌血流感染的灵敏度为57.7%,特异度为76.5%;46例多次PCT检测血培养阳性患者中,PCT呈下降趋势时患者预后较好。结论血清PCT水平的检测有助于快速排除和诊断血流感染,同时有助于区分G-菌、G+菌及真菌所致的感染;动态监测PCT变化趋势有助于患者预后的判断。     

MALDI-TOFMS-oriented early definitive therapy improves the optimal use of antibiotics for Enterococcus spp. bloodstream infection

Enterococci is one of a major cause of bloodstream infection (BSI). Because of its intrinsic drug-resistant nature, empiric antibiotic treatment tends to be inappropriate. We conducted a single-center retrospective cohort study to evaluate the impact of Matrix-assisted laser desorption and ionization time-of-flight mass spectrometry (MALDI-TOFMS) on the improvement of early antibiotic treatment for enterococcal infection. We also investigated the 28-day mortality, length of hospitalization and duration of antibiotic treatment for enterococcal bacteremia. A total of 173 BSI episodes (172 patients) between June 2012 and June 2019 were enrolled. Patients were divided into 2 groups before (n = 82) and after (n = 91) the implementation of MALDI-TOFMS (Control group and MALDI-TOF group, respectively). Almost an equal number of Enterococcus faecalis and Enterococcus faecium cases were identified in each group (51.2% and 48.8%, and 47.3% and 52.7% in each group). By implementing MALDI-TOFMS, the time to definitive antibiotic treatment was significantly improved (median 3 vs 1 days, p < 0.001). The 28-day mortality (29.3% vs 26.4%, p = 0.63) and length of hospitalization (median 16 vs 19 days, p = 0.58) were not significantly different. The duration of antibiotic treatment did not significantly differ between the two groups (median 11 vs 11 days, p = 0.78), but the duration was often shorter in older patients (>74 years old) in MALDI-TOF group, excluding those in the terminal phase of malignancy. By implementing MALDI-TOFMS, the time to definitive antibiotic treatment was significantly shortened. Although associated outcomes did not significantly differ, the duration of antibiotic treatment may be shortened.     

The first case of bloodstream infection by Candida intermedia in Japan: the importance of molecular identification

A 65-year-old Chinese man with diabetes mellitus was admitted to our hospital complaining of bloody sputum, fever, and dyspnea. Despite antibiotic treatment, his condition deteriorated, necessitating mechanical ventilation. Diffuse alveolar hemorrhage was suspected, and steroid therapy was initiated. Although his condition improved and he was extubated, the fever recurred twice, and on both occasions blood cultures yielded yeasts. The yeasts were misidentified as Cryptococcus humicola with a commercially available phenotype test (API ID32C), which did not match the clinical profile, and molecular identification was then performed. The isolates were identified as Candida intermedia by molecular phylogenetic analyses of the chromosomal regions coding for the D1/D2 domain of the large-subunit 26S rRNA gene. The patient responded well to several antifungal agents and was discharged on the 34th hospital day. To our knowledge, this is the first case of C. intermedia infection reported in Japan, and the tenth case reported in the international medical literature.     

Survey of methicillin-resistant coagulase-negative staphylococci isolated from the fingers of nursing students

 To clarify the state of methicillin-resistant coagulase-negative staphylococci (MRCNS) contamination in the hospital environment, we compared MRCNS isolated from the fingers of 40 nursing students who had not yet experienced clinical practice and 40 who had just completed clinical practice in the hospital. Fourteen MRCNS strains were detected in 13 students (32.5%) after clinical practice; Staphylococcus epidermidis in 9 students, Staphylococcus haemolyticus in 3, and Staphylococcus saprophyticus in 2. Drug sensitivity tests were performed, and the minimum inhibitory concentration (MIC) of penicillin-G (PCG) was more than 2 μg/ml in all strains, and that of ampicillin (ABPC) was more than 16 μg/ml in many strains. Only a few strains showed high MIC values for the other drugs tested. However, some Staphylococcus haemolyticus strains showed high MIC values for cefazolin (CEZ), arbekacin (ABK), gentamicin (GM), ofloxacin (OFLX), or imipenem (IPM). In all strains, the mecA gene was detected by polymerase chain reaction (PCR), and penicillin binding protein 2′ (PBP2′) was detected by the latex agglutination method. Methicillin-resistant Staphylococcus epidermidis (MRSE) isolated from the fingers of nursing students was compared with that isolated from blood culture specimens by arbitrarily primed (AP)-PCR analysis. The patterns obtained were different, a finding which excluded the presence of cross-infection. The present results show that basic preventive measures for cross-infection should be considered in the future, using such genetic analysis methods, so that MRCNS may not cause hospital infection. Received: May 27, 2002 / Accepted: September 9, 2002     

放化疗后肿瘤患者并发医院血流感染38例分析

目的研究放化疗后肿瘤患者并发医院血流感染情况，为临床合理选用抗生素提供依据。方法选取2001年11月-2004年03月患恶性肿瘤并发医院血流感染者38例，对其血液中病原菌种类及药敏情况进行分析。结果感染病原菌依次为大肠埃希菌、克雷伯菌属、表皮葡萄球菌、金黄色葡萄球菌及真菌等。革兰阴性菌及革兰阳性菌对青霉素及头孢菌素类均不同程度耐药。38例医院血流感染好转率55．3％．病死率39．5％。结论放化疗后肿瘤患者医院血流感染病原菌主要为大肠埃希菌、克雷伯菌属、真菌及葡萄球菌等。其血流感染临床表现不典型，具有隐匿性特点。故对肿瘤放化疗患者应合理选用抗菌药物，重视血流细菌感染及细菌耐药性监测工作，提高抗菌药物合理使用水平。     

Clinical and microbiological features of intratumor abscess with bloodstream infection caused by Plesiomonas shigelloides,Citrobacter freundii,Streptococcus mitis/oralis,Clostridium perfringens,and Candida albicans in a patient with cholangiocarcinoma: A case report

Plesiomonas shigelloides is a gram-negative facultative anaerobic bacillus, usually found in soil and freshwater, which causes self-limited diarrhea, although reports of bacteremia are rare. Here, we report the first case of an intratumoral abscess with mixed bacteremia caused by P. shigelloides, Citrobacter freundii, Streptococcus mitis/oralis, Clostridium perfringens, and Candida albicans in a patient with recurrent postoperative cholangiocarcinoma. A 77-year-old man with hilar cholangiocarcinoma and hypertension was admitted to our hospital with fever and abdominal pain. He had visited Vietnam for 3 years, 20 years ago. Abdominal computed tomography showed air within the recurrent tumor at the left liver lobectomy resection margin site, which was diagnosed as an intratumor abscess perforating the intestinal tract. P. shigelloides, C. freundii, S. mitis/oralis, C. perfringens, and C. albicans were isolated in blood culture. P. shigelloides was identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and 16S ribosomal RNA (16S rRNA) sequencing. Piperacillin-tazobactam was administered for almost a week, ampicillin-sulbactam and levofloxacin for almost 3 weeks, and antifungal agents for almost 2 weeks, and the patient was discharged thereafter. Although bloodstream infections caused by P. shigelloides in patients with cancer are extremely rare, long-term colonization and the potential for future intra-abdominal infections were implicated.     

降钙素原在鉴别重症监护病房血流感染患者菌种中的作用

目的 探讨血清降钙素原(procalcitonin,PCT)水平对鉴别重症监护病房(ICU)血流感染患者菌种类型的临床应用价值.方法 回顾性分析2010年1月至2012年12月广东省人民医院ICU所有血培养结果阳性且为单一菌株,并检测了血清PCT水平的患者.比较PCT水平在革兰阴性(G-)菌、革兰阳性(G+)菌及真菌血流感染患者之间的差异,同时根据受试者工作曲线(ROC)判断PCT的诊断性能.结果 纳入有效血流感染患者524例:G-菌206例,G+菌276例及真菌42例.三组PCT水平中位数分别为14.9 ng/ml、0.14 ng/ml、1.76 ng/ml,进行两两比较,组间PCT水平差异具有统计学意义(P＜0.01).根据ROC曲线,当界值设定为2.105 ng/ml时,血清PCT水平区分G-与G+菌所致血流感染的灵敏度为82.5％,特异度为80.1％;当界值设定为5.085 ng/ml时,血清PCT水平区分G-与真菌所致血流感染的灵敏度为68.0％,特异度为73.8％;G+菌与真菌的ROC曲线下面积为33.0％ (P ＜0.001).结论 血清PCT水平对鉴别G-菌与G+菌或真菌引起的ICU血流感染患者有一定的临床应用价值;但对G+菌与真菌引起血流感染的鉴别意义尚不确定.     

嗜麦芽窄食单胞菌老年下呼吸道感染48例临床分析

目的 分析嗜麦芽窄食单胞菌老年下呼吸道感染的临床特点及对抗菌药物的敏感度。方法分析48例嗜麦芽窄食单胞菌老年下呼吸道感染的临床资料。采用美国DADE公司全自动微生物分析系统MicroScan Walkaway 40系统鉴定细菌，PCIZ和NC11复合鉴定板进行体外药物敏感试验。结果48例中47例（97．9％）患有1种以上基础疾病，其中慢性阻塞性肺疾病急性加重期（AECOPD）最常见，占79％，免疫功能低下者68．8％，血浆白蛋白降低者79．2％，先期曾使用广谱抗生素者100％，曾行介入性导管治疗者72．9％。临床表现发热75％，咳嗽咳痰81．3％，肺部闻及哮鸣音或湿哕音89．6％，X线胸片多表现为两下肺片状、斑片状浸润性阴影，部分患者有胸腔积液。白细胞和中性粒细胞明显增高，C反应蛋白（CRP）增高。药敏试验结果表明该菌株耐药率高，除亚胺培南外，对氨基苷类和头孢菌素类亦普遍耐药。细菌对左氧氟沙星、环丙沙星、复方磺胺甲嗯唑的敏感度分别为89．6％、79．2％和68．8％。结论嗜麦芽窄食单胞菌老年下呼吸道感染易发生在患有多种基础疾病、免疫功能低下、血浆白蛋白降低和先期使用广谱抗菌药物及临床有介入性导管治疗患者，细菌耐药现象严重。临床上应尽早进行病原学检查，根据药敏试验结果选用合适的抗菌药物。     

耐甲氧西林金黄色葡萄球菌血流感染死亡患者临床特征及危险因素分析

目的 分析耐甲氧西林金黄色葡萄球菌(MRSA)血流感染患者临床特征及预后危险因素,为控制和预防MRSA血流感染提供依据.方法 回顾性分析2015年1月—2020年12月南京医科大学第一附属医院门诊及住院血液培养MRSA阳性患者临床特征和预后危险因素.结果 142例MRSA血流感染患者以男性、老年为主,生存99例,死亡4...