【摘要】 目的调查和分析金黄色葡萄球菌败血症的临床特点及耐药情况,为临床诊断和合理用药提供依据。方法采用血培养确诊为金黄色葡萄球菌败血症的55例患者,收集分析病史资料及相关实验室数据。结果55例患者中医院感染24例(43.6%),社区感染31例(56.4%),静脉药瘾者占社区感染9.7%。医院感染与社区感染患者临床症状、体征以及实验室检查结果无显著差异,发生迁徙性病灶者占65.5%,侵犯两个以上脏器占41.8%。医院感染患者多为合并基础疾病的老年人且具有多种易感因素,主要分布于ICU(37.4%),病死率29.2%;社区感染患者则多为青壮年(80.6%),主要分布于感染科(48.4%),病死率3.2%。医院及社区感染金黄色葡萄球菌对青霉素耐药分别为100%和96.8%,医院感染株对苯唑西林耐药率明显高于社区感染株。结论金黄色葡萄球菌败血症临床表现多较严重,重者易合并多脏器损害。所有的金黄色葡萄球菌对多种临床常用抗菌药耐药率均有所升高,因此临床上疑有败血症病例应尽早做血、骨髓培养以及药敏试验,并合理应用药物治疗。更多还原

【Abstract】 Objective To analyze clinical features of Staphylococcus aureus septicemia.Methods The clinical features and laboratory data of 55 cases with Staphylococcus aureus septicemia were retrospectively analyzed.Results Of 55 patients,24 and 31cases were nosocomial infections(43.6%) and community acquired infections(56.4%),respectively.There were no difference in clinical symptoms,signs and laboratory findings between nosocomial infections and community acquired infections.The patients with metastatic foci were 65.5%,including 41.8% with more than two organs damaged.Most of the nosocomial infectious patients were the old with severe underlying diseases and variety of vulnerable factors,which mainly distributed in ICU(37.4%).The mortality rate of the nosocomial infection was 29.2%.Community infected patients were mostly young adults(80.6%),which mainly distributed in Department of Infection(48.4%).The mortality rate of was community infected patients 3.2%.The rates of resistant to penicillin of Staphylococcus aureus isolates from hospital and community were 100% and 96.8%,respectively.The rate of resistant to oxacillin of Staphylococcus aureus isolates from hospital(75.0%) was significantly higher than that in community ones(32.3%).All the pathogens were sensitive to vancomycin,except a strain from nosocomial infection.Conclusion Clinical features of Staphylococcus aureus septicemia were severity,which often coexisted with multiple organs damaged.The rate of resistant to antimicrobial agents of Staphylococcus aureus isolates from both hospital and community acquired was increased.更多还原