人葡萄球菌耐药及临床分析

发布时间：2018-03-11 03:02

本文选题：人葡萄球菌　切入点：血流感染　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的了解我院人葡萄球菌血流感染的临床特点、耐药情况。方法采用回顾性分析,对我院2008年-2015年间血中分离到人葡萄球菌101例病例的一般资料、临床症状、实验室检查结果、药敏结果等分析。结果95例存在基础疾病,79(78.2%)例存在免疫缺陷,49例患者有长期留置导管,不恰当用药、年龄60岁及合并肿瘤为预后不佳的相关因素,不恰当用药OR 2.1(95%CI 0.8～5.6,P=0.013)、合并恶性肿瘤(OR 3.1(95%CI 1.138-8.448,P=0.027))是影响预后的独立危险因素。人葡萄球菌污染率67%,药敏结果显示人葡萄球菌对红霉素、苯唑西林、四环素、复方新诺明等抗生素耐药率高万古霉素、喹努普汀/达福普汀、利奈唑胺耐药率低;2003-2016年无菌体液中耐甲氧西林株比例基本无变化,对复方新诺明耐药率呈下降趋势,环丙沙星、庆大霉素、红霉素耐药率未见明显上升或下降变化,对万古霉素耐药的葡萄球菌1株,利奈唑胺耐药2株,达托霉素耐药5株;结论不恰当用药、合并恶性肿瘤为影响人葡萄球菌血流感染预后的独立危险因素,人葡萄球菌多重耐药常见,13年间耐甲氧西林、环丙沙星、庆大霉素、红霉素比率无明显变化。
[Abstract]:Objective to investigate the clinical characteristics and drug resistance of staphylococcus human blood stream infection in our hospital. Methods A retrospective analysis was made on the clinical symptoms of 101 cases of staphylococci isolated in blood from 2008 to 2015 in our hospital. Results 95 cases of basic diseases (79 78.2%) and 49 cases of immunodeficiency (49 cases) had long-term indwelling catheter, inappropriate drug use, age 60 years old and complicated with tumor as the related factors of poor prognosis. The inappropriate use of OR 2.1 + 95CI 0.85.6C 0.013, or 3.1c95 CI 1.138-8.448P0.027) was an independent risk factor affecting the prognosis. The contamination rate of staphylococcus was 67g, and the drug-sensitive results showed that staphylococcus had a positive response to erythromycin, oxacillin and tetracycline, and that there was no significant difference between staphylococci and erythromycin, oxacillin and tetracycline in the treatment of staphylococci. High vancomycin resistance rate, quinaputin / dafopudine resistance rate and low resistance rate of linazolamide in compound sulfamine and other antibiotics showed no change in the proportion of methicillin-resistant strains in aseptic body fluid from 2003 to 2016, but the resistance rate to compound sulfamide showed a decreasing trend. The resistance rate of gentamicin to erythromycin did not increase or decrease obviously. One strain of vancomycin resistant staphylococcus, 2 strains of linazolamide and 5 strains of daptomycin were resistant to vancomycin. Malignant tumor was an independent risk factor for the prognosis of staphylococcal infection. There was no significant change in methicillin, ciprofloxacin, gentamicin and erythromycin ratios during 13 years of multidrug resistance of staphylococcus.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R515;R446.5

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