76例金黄色葡萄球菌医院感染患者的临床分析

目的：探讨2006年本院金黄色葡萄球菌（金葡菌）医院感染患者的临床影响因素及耐药情况。方法：回顾本院被确诊为医院感染的住院患者，分析其中金葡菌医院感染患者的临床特点、病原菌分布及耐药情况；并将非金葡菌医院感染患者作为对照组．采用Kirbv—Bauer琼脂扩散测定病原菌对抗菌药物的敏感度，并对患者的性别、年龄构成、原发疾病、所在病区、诊疗经过、诱发因素等资料进行回顾性调查，并进行统计分析。结果：2006年本院共有金葡菌培养阳性标本495例次．确诊为医院感染者96例次，其中91例次（76例患者）病史资料完整，非金葡菌医院感染354例次。76例中死亡20例．占2006年本院金葡菌医院感染者的26.32％。性别、年龄对金葡菌医院感染的发生无显著影响，而金葡菌医院感染发病最多的病区为神经外科，占30．77％（28例次／91例次）。下呼吸道标本培养金葡萄阳性者占所有金葡菌医院感染者的79．16％。诱发金葡菌医院感染的因素为手术、留置导尿、深静脉穿刺等侵入性操作。金葡菌对万古霉素敏感率为98.90％。结论：2006年本院金葡菌医院感染以神经系统疾病住院患者高发，可能与其原发病重、一般情况差有关.金葡菌感染以呼吸道为主，最主要的诱发因素为手术.

Clinical analysis of 76 patients with nosocomial infection of Staphylococcus aureus

Objective To explore the clinical impacting factors and resistance profile of nosocomial Staphylococcus aureus infection occurred in our hospital in year 2006 so as to provide a strategic basis for its prevention and management. Methods Patients with nosocomial staphylococcus aureus infection from Jan.2006 to Dec. Seventy-six patients were analyzed retrospectively for their clinical features, ward where infection occurred and drug-resistance profile. Results Ninety one cases were included in this study. Mortality rate was 26.32% （20/76）. Nosocomial staphylococcus aureus infection was not influenced by gender and age of patient.30.77% （28/91） of the cases were hospitalized patients in neurosurgery ward. Sputum culture was positive in 79.16% of cases, which indicated that respiratory tract was the main route for the spreading of staphylococcus aureus infection.Predisposing factors were the invasive procedure such as surgical operation, retention of urinary catheter, deep vein puncture, et al. 98.90% of the Staphylococcus aureus isolated were sensitive to vancomycin,which declined from 100% of several years ago. Conclusions Patients with neurologic diseases were of dominance in this study. This may be due to the high severity of disease and the poor overall health status. The infection was disseminated mainly via respiratory. tract and the main predisposing factors were surgical operation, retention of urinary catheter and deep vein puncture.