耐甲氧西林金黄色葡萄球菌感染的耐药性分析及利奈唑胺治疗效果的研究

Drug Resistance in ICU by Meticillin-resistant Staphylococcus aureus Infection and Effect of Linezolid

目的通过对重症监护病房(ICU)耐甲氧西林金黄色葡萄球菌(MRSA)感染的分析,探讨其耐药性;并观察利奈唑胺在MRSA感染中的治疗效果。方法收集ICU 2006年3月-2009年3月入住ICU患者的痰、血、尿、脑脊液、中心静脉穿刺针顶端及局部引流物进行细菌学培养及药物敏感性试验,其中15例MRSA感染患者应用利奈唑胺治疗。结果ICU 3年共发生MRSA感染72例,绝大多数为耐药菌;万古霉素、替考拉宁和利奈唑胺对MRSA感染的敏感率高,均为100%;ICU近3年MRSA有逐年升高的趋势,利奈唑胺组的有效率和痊愈率分别为73.3%和33.3%,均高于万古霉素组(66.7%和28.6%)(P<0.05)。结论ICU中MRSA的感染率较高,必须引起重视,利奈唑胺是MRSA感染的有效药物,且不良反应较少。

OBJECTIVE To explore the drug resistance of the infection caused by meticillin-resistant Staphylococcus aureus （MRSA） in ICU and the effect of linezolid in the treatment on MRSA. METHODS The collection of sputum, blood, urine, cerebrospinal fluid, the top and local drainage of central venous needle in 3 years（2006 to 2009） in ICU was carried out,and the bacteriological culture and drug susceptibility testing were executed. Fifteen cases of MRSA infection patients were treated with linezolid. RESULTS There were 72 cases of MRSA infection in 3 years in ICU,most of them were drug-resistant. The sensitivity for MRSA infection was high to 100% by used with vancomycin, teicoplanin and linezolid. The trend of MRSA infection in ICU had increased in the past 3 years. The efficiency and recovery rates of linezolid group （73. 3% and 33. 3%, respectively） were higher than the vancomycin group （66.7% and 28. 6%, respectively） （P〈0.05）. CONCLUSIONS The infection rates of MRSA are high in ICU, so we must pay attention to it. Linezolid is an effective drug for MRSA infection, and the adverse reactions were few.