血液感染金黄色葡萄球菌耐药性及甲氧西林耐药株危险因素分析  

Analysis of drug resistance of Staphylococcus aureus isolated from bloodstream and risk factors of methicillin-resistant strains

作　　者：张昭勇[1] 张吉才[1] 谢飞[1] 娄国平[1] 李显东[1] 

机构地区：[1]湖北医药学院附属太和医院检验部,湖北十堰442000

出　　处：《检验医学与临床》2013年第18期2380-2382,共3页Laboratory Medicine and Clinic

摘　　要：目的分析血液感染金黄色葡萄球菌耐药性及甲氧西林耐药株感染的危险因素。方法对本院2009~2011年金黄色葡萄球菌血液感染患者流行病学资料进行回顾性研究。将感染患者分为甲氧西林敏感（MSSA）组和耐药组（MRSA）,然后采用1∶2成组病例对照方法选取同时期非金黄色葡萄球菌感染患者作为对照组,对MRSA血液感染危险因素进行分析。结果血液标本分离的289株金黄色葡萄球菌中192株为甲氧西林耐药株,占66.90%,MRSA组耐药性明显高于MSSA组。甲氧西林耐药组和敏感组感染患者的病死率均高于对照组,但是MRSA组与MSSA组病死率比较差异无统计学意义。Logistic回归分析显示,重症监护室（ICU）入住（〉7d）、中心静脉置管、联合用药大于2种和抗生素使用时间大于2周是MRSA感染的独立危险因素。结论血液分离金黄色葡萄球菌MRSA株检出率高、耐药性强,患者的病死率高。MRSA血液感染具有多个独立危险因素,加强对这些独立危险因素的控制可有效预防其感染扩散。Objective To analyze the drug resistance of Staphylococcus aureus（SA）isolated from blood samples of patients with bloodstream infections（BSI）and the risk factors of methicillin-resistant SA（MRSA）.Methods Data of all SA strains isolated from blood of patients with BSI during 2009and 2011were retrospectively analyzed.Patients with BSI were divided into two groups,including methicillin-sensitive SA（MSSA）infection group and MRSA infection group,and infection patients not caused by SA were enrolled as control group.The risk factors of MRSA blood infection were analyzed.Results 289strains of SA were isolated,66.90%（192/289）of which were MRSA.Drug resistance of MRSA group was higher than the MSSA group.Morality rates of MRSA group and MSSA group were higher than control group,but the difference between MRSA group and MSSA group was not significant.Logistic regression analysis indicated that ICU occupancy（7d）,central venous catheter,combined use of antibiotics and therapeutic time of antibiotics more than 2weeks were the independent risk factors of BSI caused by MRSA.Conclusion The detectable rate and drug resistance rate of MRSA,isolated from BSI patients caused by SA,might be extremely serious,and the mortality of patients might be high.BSI caused by MRSA could be correlated with various independent rick factors,which should be effectively controlled.

关 键 词：血液感染 耐甲氧西林金黄色葡萄球菌 耐药性 危险因素 

分 类 号：R446.5[医药卫生—诊断学]