实用药物与临床
實用藥物與臨床
실용약물여림상
PRACTICAL PHARMACY AND CLINICAL REMEDIES
2015年
1期
79-82
,共4页
金黄色葡萄球菌%耐甲氧西林金黄色葡萄球菌( MRSA)%耐药性%万古霉素%感染
金黃色葡萄毬菌%耐甲氧西林金黃色葡萄毬菌( MRSA)%耐藥性%萬古黴素%感染
금황색포도구균%내갑양서림금황색포도구균( MRSA)%내약성%만고매소%감염
Staphylococcus aureus%Methicillin resistant Staphylococcus aureus%Drug resistance%Vancomycin%In-fection
目的：探讨老年人感染MRSA的临床特点及耐药性，为临床合理用药及预防其感染提供依据。方法采用回顾性分析方法，对我院2012年1月至2014年9月期间获得耐甲氧西林金葡菌感染的老年患者(≥65岁)110例进行感染现状和耐药性分析。结果110例耐甲氧西林金黄色葡萄球菌院内感染的高危因素有：住院时间长、高龄、合并严重基础疾病、使用了广谱抗菌药物、进行过创伤性操作。对110株耐甲氧西林金葡菌耐药性检测结果：患者对绝大多数抗菌药物表现为耐药，对苯唑西林、青霉素G、阿莫西林克拉维酸、氨苄西林、氨苄西林舒巴坦、亚胺培南、头孢唑啉、头孢唑南钠的耐药率达到100%，对红霉素、环丙沙星、罗米沙星、左氧氟沙星的耐药率大于90%，而对万古霉素、利奈唑胺、替加环素、呋喃妥因、复方新诺明比较敏感，在对我院的临床调查研究中尚未发现对其耐药的菌株。结论减少住院天数、积极治疗基础疾病、合理使用抗菌药物、严格掌握各种临床侵入性操作指征、及时调整用药有益于减少该类细菌的感染几率。对于临床经验治疗来说，青霉素类和红霉素类药物耐药率高，已经不适合。对MRSA加强检测及耐药性监测，有益于指导临床用药。
目的：探討老年人感染MRSA的臨床特點及耐藥性，為臨床閤理用藥及預防其感染提供依據。方法採用迴顧性分析方法，對我院2012年1月至2014年9月期間穫得耐甲氧西林金葡菌感染的老年患者(≥65歲)110例進行感染現狀和耐藥性分析。結果110例耐甲氧西林金黃色葡萄毬菌院內感染的高危因素有：住院時間長、高齡、閤併嚴重基礎疾病、使用瞭廣譜抗菌藥物、進行過創傷性操作。對110株耐甲氧西林金葡菌耐藥性檢測結果：患者對絕大多數抗菌藥物錶現為耐藥，對苯唑西林、青黴素G、阿莫西林剋拉維痠、氨芐西林、氨芐西林舒巴坦、亞胺培南、頭孢唑啉、頭孢唑南鈉的耐藥率達到100%，對紅黴素、環丙沙星、囉米沙星、左氧氟沙星的耐藥率大于90%，而對萬古黴素、利奈唑胺、替加環素、呋喃妥因、複方新諾明比較敏感，在對我院的臨床調查研究中尚未髮現對其耐藥的菌株。結論減少住院天數、積極治療基礎疾病、閤理使用抗菌藥物、嚴格掌握各種臨床侵入性操作指徵、及時調整用藥有益于減少該類細菌的感染幾率。對于臨床經驗治療來說，青黴素類和紅黴素類藥物耐藥率高，已經不適閤。對MRSA加彊檢測及耐藥性鑑測，有益于指導臨床用藥。
목적：탐토노년인감염MRSA적림상특점급내약성，위림상합리용약급예방기감염제공의거。방법채용회고성분석방법，대아원2012년1월지2014년9월기간획득내갑양서림금포균감염적노년환자(≥65세)110례진행감염현상화내약성분석。결과110례내갑양서림금황색포도구균원내감염적고위인소유：주원시간장、고령、합병엄중기출질병、사용료엄보항균약물、진행과창상성조작。대110주내갑양서림금포균내약성검측결과：환자대절대다수항균약물표현위내약，대분서서림、청매소G、아막서림극랍유산、안변서림、안변서림서파탄、아알배남、두포서람、두포서남납적내약솔체도100%，대홍매소、배병사성、라미사성、좌양불사성적내약솔대우90%，이대만고매소、리내서알、체가배소、부남타인、복방신낙명비교민감，재대아원적림상조사연구중상미발현대기내약적균주。결론감소주원천수、적겁치료기출질병、합리사용항균약물、엄격장악각충림상침입성조작지정、급시조정용약유익우감소해류세균적감염궤솔。대우림상경험치료래설，청매소류화홍매소류약물내약솔고，이경불괄합。대MRSA가강검측급내약성감측，유익우지도림상용약。
Objective To investigate the clinical characteristics and drug resistance of methicilin resistant Staphylococcus aureus( MRSA) in elderly patients,in order to provide an important basis for proper clinical use of anti-biotics and prevention of infection with MRSA. Methods A retrospective analysis was carried out on analyzing the in-fection status and drug resistance in 110 cases of elderly patients ( age≥65 ) who were infected MRSA from January 2012 to September 2014. Results High risk factors of MRSA:long time hospitalization,advanced age,severe basic diseases,the use of broad-spectrum antibiotics,having traumatic operation. The result of detection of MRSA resistance showed that the elderly patients( age≥65 ) infected with MRSA were resistant to most antibiotics. The drug resistance rates of oxacilin, penicillin G, amoxicillin clavulanic acid, ampicillin ampicillin sulbactam, imipenem, cefazolin, cefu-zonamsodium were 100%. The drug resistance rates of erythromycin,ciprofloxacin,lomefloxacin and levofloxacin were more than 90%. No drug was resistant to vancomycin,linezolid,tigecycline,nitrofurantoin,cotrimoxazole. Conclusion Shorten the length of hospitalization,actively treating basic diseases,proper clinical use of antibiotic,mastering the knowledges of various clinical indications of invasive operation,timely adjusting medication can decrease the infection rate of the kind of bacterium. Penicillin and erythromycin drug resistant rates are too high to clinical application. Strengthening the MRSA detection and drug resistance monitoring is beneficial to clinical medication.
