某院336例医院获得性肺炎患者金黄色葡萄球菌感染情况及耐药性研究  

Infection and drug resistance of staphylococcus aureus in patients with hospital-acquired pneumonia

作　　者：卓安山[1] 官振标[1] 李奕[1] 徐世林[1] 童皖宁[1] 孙星[1] 赵红霞[1] 李雷[1] 

机构地区：[1]解放军第四一一医院呼吸科,上海200081

出　　处：《海军医学杂志》2017年第6期527-529,共3页Journal of Navy Medicine

摘　　要：目的了解医院获得性肺炎(HAP)患者金黄色葡萄球菌(下简称金葡菌)感染的分布情况及其对常用抗菌药物的耐药性,以期为临床合理应用抗菌药物提供依据。方法回顾性分析本院2011年1月至2015年12月间住院的336例HAP患者金葡菌感染情况及细菌耐药性。结果 336例HAP患者共分离出金葡菌93株(占27.7%),其中甲氧西林耐药金葡菌(MRSA)78株,占83.9%;5年间HAP患者金葡菌感染率分别为29.6%、26.7%、26.9%、25.3%和30.1%,各年间差异无统计学意义(P>0.05);细菌耐药性分析发现,本组HAP-MRSA感染者对万古霉素和利奈唑胺的敏感性为100%,对复方磺胺甲恶唑和利福平的敏感性约70%左右,对其他常用抗生素如β内酰胺类、大环内酯类和氟喹诺酮类药物的敏感性均较低(<30%)。结论金葡菌依然是HAP患者主要的革兰阳性致病菌,且多为MRSA感染,临床应用抗生素治疗HAP-MRSA感染,应首选万古霉素和利奈唑胺。Objective To investigate the infection distribution of the hospital-acquired pneumonia(HAP) in patients with Staphylococcus aureus(S.aureus) and its drug resistance to those commonly-used antimicrobial agents,so as to provide evidence for rational use of antibacterial drugs clinically.Methods Retrospective analysis of the infection status and drug resistance of Staphylococcus aureus in 336 cases of HAP treated in the hospital from January 2011 to December 2015 was made in the study.Results(1)Ninety-three strains of Staphylococcus aureus were isolated from the 336 cases of HAP(27.7%),including 78 strains of methicillin-resistant Staphylococcus aureus(MRSA),accounting for 83.9%.(2) The infection rates of Staphylococcus aureus for the HAP patients in the five years were respectively 29.6%,26.7%,26.9%,25.3% and 30.1%.There were no statistical differences in infection rates,when comparisons were made between the years(P>0.05).(3) Bacterial resistance analysis indicated that the patients with HAP-MRSA infection were completely sensitive to vancomycin and linezolid(by 100%),fairly sensitive to compound sulfamethoxazole and rifampicin(by about 70%) and other antibiotics,such as beta lactams,macrolides and fluoroquinolones,was poorly sensitive(by as low as less than 30%).Conclusion In HAP patients,Staphylococcus aureus was the main Gram positive pathogen,with MRSA infection being the main case.Vancomycin and linezolid should be the first choice of drugs in clinical application of antibiotics for the treatment of HAP-MRSA infection.

关 键 词：医院获得性肺炎 葡萄球菌 细菌感染 耐药性 

分 类 号：R378[医药卫生—病原生物学]