【摘要】 本文报告1962～1978年16年间血培养阳性195例金葡菌败血症,探讨其临床类型,分析各种与予后有关的因素,井根据60年代与70年代两个时期金葡菌耐药性的变迁,提出今后一段时期内本地区金葡菌感染的抗生素选用.更多还原

【Abstract】 The article deals with 195 proved cases of S. aureus septicemia in our hospital from 1962 to 1978. Fatality was 12.8%. According to the presence or absence of the primary focus of infection,the cases were divided into two groups. The incidences of foci secondary to septicemia in these two groups were 45.8% and 65.2% (P<0.01), and fatalities 6.0% and 17. 9% (0. 01<P<0. 05) respectively. This study suggests that the prognosis of septicemia without the primary focus v/as much poorer. The factors causing poor prognosis include : duration of the illness before admission> 10 days (P<0.01) ; presence of coma(P<0.01) ; temperature<39 ℃ (P<0.01); WBC<6, 000 ( P<0.01 ) ; and the presence of metastatic lesions of the heart or central nervous system.The resistance patterns of S. aureus in 1970 s were different from those in 1960’s. In the latter half period of our observation S. aureus was no longer susceptible to tetra-cycline and aureomycin. The resistant strains to these two antibiotics have increased to 95.2% and nearly 100% respectively. As a result, neither agent should be recommended for curative therapy of this disease. The resistant strains to penicillinasc resistant penicillins have also increased to 30.8%, hence, a higher dosage of the agents is requisite for cure. As kanamycin nd gcntamycin resistant strains are still rare at present, these agents should be taken as the drugs of choice for severe S. aureus infections. In addition, as most strains of S. aureus remain susceptible to erythromycin or chloramphenicol to which the resistant strains account for only 13.9% and 12.2% respectively, these agents may ,be used as alternatives.更多还原