重症烧伤患者医院内MRSA感染的危险因素及利奈唑胺的临床疗效评价  

Risk factors of nosocomial MRSA infection in severe burn patients and clinical efficacy evaluation of linezolid

作　　者：程振宇[1] 王帅[1] 唐丽平 李晓亮[1] Cheng Zhenyu;Wang Shuai;Tang Liping;Li Xiaoliang(Department of Pharmacy,the First People’s Hospital of Zhengzhou,Zhengzhou 450000)

机构地区：[1]郑州市第一人民医院药学部,河南郑州450000

出　　处：《中国现代医药杂志》2024年第8期5-9,共5页Modern Medicine Journal of China

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200700)。

摘　　要：目的分析重症烧伤患者院内出现耐甲氧西林金黄色葡萄球菌(MRSA)感染的危险因素并评价利奈唑胺的临床疗效。方法选择2022年5月~2023年2月在我院烧伤科进行治疗的重症烧伤患者152例,将出现MRSA感染的患者设为感染组,出现MSSA感染的患者设为对照组,各76例。对患者一般资料进行分析。使用不同剂量的利奈唑胺治疗,将感染组患者分为低剂量组和高剂量组,各38例,对比患者临床疗效以及不良反应发生情况。结果患者治疗期间的抗菌药物使用时间、Ⅲ度烧伤和医护人员侵入操作时间均会对重症烧伤患者出现院内MRSA感染有影响,差异有统计学意义(P<0.05),患者年龄、侵入操作种类、致病菌种数、性别、手术次数和换药次数对患者MRSA感染影响较小,差异无统计学意义(P>0.05);相关性分析中,抗菌药物使用时间、Ⅲ度烧伤和侵入操作时间均和重症烧伤患者出现医院MRSA感染呈正相关(P<0.05);多因素Logistic分析中,Ⅲ度烧伤、患者的抗菌药物使用时间以及医护人员的侵入操作时间均是重症烧伤患者出现院内MRSA感染的相关危险因素(P<0.05);经过对比,利奈唑胺高剂量组患者的临床疗效明显好于低剂量组(P<0.05);低剂量组患者的不良反应发生率明显低于高剂量组,差异有统计学意义(P<0.05)。结论抗菌药物使用时间、Ⅲ度烧伤和侵入操作时间是造成重症烧伤患者院内发生MRSA感染的危险因素,使用高剂量利奈唑胺治疗的疗效较好,但是不良反应发生率较高。Objective To invesigate the risk factors for methicillin-resistant Staphylococcus aureus(MRSA)infection in hospitals with severe burns and evaluate the efficacy of linezolid.Methods A total of 152 cases of severe burn patients from the department burns in our hospital from May 2022 to Feb 2023 were selected,patients with MRSA infection were divided into infection group and patients with MSSA infection were divided into control group,76 cases in each group.The general data of patients were analyzed.The patients in the infection group were divided into low-dose group and high-dose group with 38 cases in each group according to different doses of linezolid treatment,and the clinical efficacy and adverse reactions of patients were compared.Results The use time of antibiotics,third-degree burn and the time of medical staff's invasive operation during the treatment of patients had an impact on the occurrence of nosocomial MRSA infection in patients with severe burn,with significant differences(P<0.05).The age of patients,the type of invasive operation,the number of pathogenic bacteria,gender,the number of operations and dressing changes had little effect on MRSA infection,and there was no significant difference(P>0.05).The correlative analysis showed the use time of antibiotics,third-degree burn and the time of invasive operation had a positive correlation with the occurrence of nosocomial MRSA infection in patients with severe burn(P<0.05).Logistic analysis showed that third-degree burns,use time of antibiotics,time of invasive operations were dangerous factors of MRSA infection in the severe burn room.In contrast,the clinical outcomes of patients with high doses of linezolid were significantly better than those with low doses(P<0.05).The incidence of adverse reactions in the low dose group was significantly lower than that in the high dose group(P<0.05).Conclusion The use time of antibiotics,third-degree burn and the time of invasive operation are the risk factors of nosocomial infection of MRSA in patients with seve

关 键 词：重症烧伤 利奈唑胺 危险因素 

分 类 号：R644[医药卫生—外科学]