CAJ | 학술논문

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M RS A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（＞7 d）、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M RSA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。
목적분석혈액감염금황색포도구균내약성급갑양서림내약주감염적위험인소。방법대본원2009～2011년금황색포도구균혈액감염환자류행병학자료진행회고성연구。장감염환자분위갑양서림민감（MSSA）조화내약조（MRSA），연후채용1∶2성조병례대조방법선취동시기비금황색포도구균감염환자작위대조조，대M RS A혈액감염위험인소진행분석。결과혈액표본분리적289주금황색포도구균중192주위갑양서림내약주，점66．90％，MRSA조내약성명현고우MSSA조。갑양서림내약조화민감조감염환자적병사솔균고우대조조，단시MRSA조여MSSA조병사솔비교차이무통계학의의。Logistic회귀분석현시，중증감호실（ICU）입주（＞7 d）、중심정맥치관、연합용약대우2충화항생소사용시간대우2주시M RSA감염적독립위험인소。결론혈액분리금황색포도구균MRSA주검출솔고、내약성강，환자적병사솔고。MRSA혈액감염구유다개독립위험인소，가강대저사독립위험인소적공제가유효예방기감염확산。
Objective To analyze the drug resistance of Staphylococcus aureus (SA) isolated from blood sam-ples 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 2009 and 2011 were retrospectively analyzed . Patients with BSI were divided into two groups ,including methicillin-sensitive SA (MSSA) infection group and MR-SA infection group ,and infection patients not caused by SA were enrolled as control group .The risk factors of MR-SA blood infection were analyzed .Results 289 strains of SA were isolated ,66 .90% (192/289) of which were MR-SA .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 signifi-cant .Logistic regression analysis indicated that ICU occupancy (>7 d) ,central venous catheter ,combined use of antibiotics and therapeutic time of antibiotics more than 2 weeks 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 .