某医院99例金黄色葡萄球菌血流感染患者临床特征分析

Characteristics of 99 cases of Staphylococcus aureus bloodstream infection

目的了解金黄色葡萄球菌血流感染的特点。方法收集2013年1月—2020年12月99例由金黄色葡萄球菌所致血流感染的患者资料,对其特点进行回顾性分析。结果48例院内获得性金黄色葡萄球菌血流感染患者中,院内获得性耐甲氧西林金黄色葡萄球菌(HA-MRSA)感染占54.2%。51例社区获得性金黄色葡萄球菌血流感染患者中,社区相关性耐甲氧西林金黄色葡萄球菌(CA-MRSA)占15.7%。患者主要来自感染科(21.2%)、肾内科(17.2%)和重症监护病房(9.1%)。61~80岁患者耐甲氧西林金黄色葡萄球菌(MRSA)血流感染比例最高。MRSA组未发现对万古霉素、利奈唑胺、替考拉宁、替加环素耐药菌株。复方新诺明对所有CA-MRSA菌株敏感,利福平对所有HA-MRSA菌株敏感。金黄色葡萄球菌血流感染患者最多的基础疾病是糖尿病(27.3%)和慢性肾病(19.2%)。多因素结果分析显示,脓毒性休克是预后不良的独立危险因素。结论HA-MRSA检出率高,糖尿病和慢性肾病基础疾病者多见,脓毒性休克是预后不良的独立危险因素。

Objective To investigate the characteristics of S.aureus(SA)bloodstream infections.Methods The data were collected from 99 patients with SA bloodstream infections from January 2013 to December 2020.The characteristics of the strains were analyzed retrospectively.Results Among the 48 cases of hospital-acquired SA bloodstream infection,hospital-acquired methicillin-resistant SA(HA-MRSA)accounted for 54.2%.Meanwhile,community-associated MRSA(CA-MRSA)accounted for 15.7%in the 51 patients with community-acquired SA bloodstream infection.The patients were mainly from infection department(21.2%),nephrology department(17.2%)and intensive care unit(9.1%).Patients aged 61-80 years had the highest proportion of MRSA bloodstream infection.No strains resistant to vancomycin,linezolid,teicoplanin and tegacyclin were found in MRSA.Cotrimoxazole was sensitive to all CA-MRSA strains,and rifampicin was also sensitive to all HA-MRSA strains.The most common basic diseases of SA bloodstream infection were diabetes mellitus(27.3%)and chronic kidney disease(19.2%).Multivariate analysis showed that septic shock was an independent risk factor for poor prognosis.Conclusion The detection rate of HA-MRSA in patients with hospital-acquired SA bloodstream infection is high.The most common basic diseases of SA bloodstream infection are diabetes mellitus and chronic kidney disease.Septic shock is an independent risk factor for poor prognosis.