医院内甲氧西林耐药金黄色葡萄球菌肺部感染高危因素 …

目的 探讨医院内甲氧西林耐药金黄色葡萄球菌（ＭＲＳＡ０肺部感染的主要危险因素。方法 １９９６￣１９９８年住院诊断为ＭＲＳＡ肺部感染患者６４例，分析感染的危险因素。结果 ６４例ＭＲＳＡ肺部感染患者，死亡２８例，占发病的４４％。合并真菌感染１８例、肺炎克雷伯杆菌１１例、嗜麦芽假单胞菌９例、肠球菌７例，合并嗜麦芽假单胞菌感染者病死率最高，为６７％，其次真菌为６１％。发热２３例，病死率７８％；体温正常４１

High risk factors lead to noscomial pulmonary infections caused by MRSA

OBJECTIVE: To investigate major risk factors leading to death by noscomial MRSA pulmonary infections. METHOD: The data of hospitalized patients diagnosed as noscomial MRSA pulmonary infections were sorted out and analyzed for recent three years. RESULTS: Case mortality of 64 patients with noscomial MRSA pulmonary infections were 44%. Of these, 18 cases complicated fungi, 11 Klebsiella pneumoniae, 9 Pseudomonas maltophilia and 7 Enterococcus. Case mortality of fungi and Pseudomonas maltophilia were 67% and 61%, respectively. 23 cases had fever, 18 died (case mortality 78%) and 41 had no fever, 10 died (case mortality 24%) (chi 2 = 15.253, P < 0.005). The case mortality with reduction, normal and increase of leukocyte were 80%, 24% and 45%, respectively. The comparison between three groups had obvious significance (chi 2 = 12.554, P < 0.005) and the case mortality of leukocytopenia was higher than that of other two groups (chi 2 = 8.626, P < 0.005). The case mortality of hypoproteinemia was higher than that of the control group (chi 2 = 6.914, P < 0.01). The patients who developed fulminant lesions in liver, kidneys and lungs showed higher mortality rate. CONCLUSIONS: Case mortality of noscomial pneumonia caused by MRSA is very high. In addition to common causes, underling diseases, leukocytopenia, malnutrition and complex infections are also risk factors of MRSA infection.