78例耐甲氧西林葡萄球菌感染临床分析及其对预后的影响

目的 了解耐甲氧西林葡萄球菌（MRS）的感染状况及其对患者住院天数、医疗费用和病死率的影响,为MRS感染的临床治疗提供依据.方法 对78例MRS和50例甲氧西林敏感葡萄球菌（MSS）感染的患者进行回顾性分析.结果 发生院内MRS感染的65例患者中,64例有长期使用抗生素史.感染的部位主要为下呼吸道和手术切口,分别为43.6%和25.6%,培养的MRS以耐甲氧西林金黄色葡萄球菌比例最高（53.8%）.MRS感染患者的住院时间、医疗费用、病死率均显著性长于和高于MSS感染者（P＜0.05）.MRS对万古霉素和利奈唑胺的敏感性最高,未发现耐药者,其次为替考拉宁,敏感率为98.6%.结论 MRS感染以下呼吸道和手术切口为主,合理使用抗生素对MRS感染的预防至关重要.发生感染时,万古霉素和利奈唑胺为其最佳选择的抗菌药物.

Clinical analysis and influence on prognosis of 78 cases of Methicillin-resistant Staphylococcus infection

Objective To investigate infection of Methicillin-resistant Staphylococcus （MRS）and influence on Methieillin-sensitive Staphylococcus （MSS）in total hospital days, medical expense and mortality rate, and to provide clinical evidence for treatment and control of MRS infection. Methods 78 cases of MRS and 50 cases of MSS infections were analysed retrospectively. Results 64 cases have been administrated with antibiotics for a long period among 65 cases of nosocomial MRS infections. The staphylococcus strain isolated mostly from lower respiratory and surgical site wound, which accounted for 43.6% and 29.5% respectively. The main pathogen was Staphylococcus aureus （53.8%）. The hospital days, medical expense and mortality rate of patients who were infected with MRS were significantly longer and higher than those infected with MSS. Drug sensitive tests showed MRS was the most sensitive to vancomycin and linezolid,and resistant strain was not found. The sensitive rate to teicoplanin was 98.6%. Conclusion It is very important to use antibiotics rationally to prevent MRS infections which mainly occurred in lower respiratory tract and surgical site wound. Vancomycin and linezolid are the most effective antibiotics to MRS infection.