骨外伤病人耐甲氧西林金黄色葡萄球菌的耐药性变迁及感染因素分析

发布时间：2018-07-07 15:36

  本文选题：骨外伤病人 + 耐甲氧西林金黄色葡萄球菌　； 参考：《中国病原生物学杂志》2016年11期

【摘要】：目的研究骨外伤病人耐甲氧西林金黄色葡萄球菌(MRSA)的耐药性变迁及相关感染因素,为控制病原菌感染及耐药性发展提供指导。方法收集本院2012-2015年骨外伤病人伤口分泌物等标本分离病原菌,鉴定MRSA菌株并进行药敏试验,对耐药性及影响因素进行分析。结果 1 874例骨外伤患者中共分离MRSA179株,其中分离自伤口分泌物、脓液分泌物、中心静脉血、痰咽拭子以及鼻拭子标本中的MRSA菌株数分别为72、46、33、19和9株。2012-2015年各年度分离菌株数分别为27、33、55和64株。2012年MRSA临床分离株对头孢唑啉、头孢噻肟、庆大霉素、环丙沙星、四环素、左氧氟沙星、克林霉素、万古霉素的耐药率分别为51.85%、33.33%、29.63%、22.22%、85.19%、37.04%、59.26%、0.00%;2013年MRSA耐药率分别为57.58%、33.33%、42.42%、33.33%、75.76%、51.52%、51.52%、0.00%;2014年MRSA耐药率分别为67.27%、38.18%、45.45%、36.36%、81.82%、49.09%、60.00%、0.00%;2015年MRSA耐药率分别为68.75%、42.19%、46.88%、39.06%、82.81%、60.94%、71.88%、0.00%。2012-2015年MRSA对万古霉素敏感,对其他各检测抗菌药物的耐药率呈逐年升高趋势。患者的年龄和治疗中联合用药种类与其感染MRSA的发生无关(P0.05),而骨外伤患者感染MRSA的发生与患者性别、住院时间长短、是否接受手术治疗以及自身是否患有糖尿病有关(P0.01)。结论骨外伤病人感染MRSA以伤口分泌物样本居多,菌株对各种抗菌药物的耐药程度呈整体增高趋势,但对万古霉素敏感。骨外伤病人MRSA感染治疗时时应考虑住院时间、是否接受手术治疗以及是否患有糖尿病等因素。
[Abstract]:Objective to study the changes of drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) and the related infection factors in bone trauma patients, and to provide guidance for the control of pathogenic bacteria infection and the development of drug resistance. Methods pathogenic bacteria were isolated from wound secretion of bone trauma patients in our hospital from 2012 to 2015. MRSA strains were identified and drug sensitivity test was carried out. Drug resistance and influencing factors were analyzed. Results the MRSA 179 strains were isolated from 1 874 patients with bone trauma, including wound secretions, pus secretions and central venous blood. The number of MRSA strains in sputum swabs and nasal swabs were 722, 46, 3319 and 9 strains, respectively. In 2012-2015, the number of MRSA isolates in each year were 270.35 and 64, respectively. The clinical isolates of MRSA in 2012 were cefazolin, cefotaxime, gentamicin, ciprofloxacin, tetracycline, cefazolin, cefotaxime, gentamycin, ciprofloxacin and tetracycline, respectively. 宸︽哀姘熸矙鏄，

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