Atsumi N
Department of Surgery, University of Tsukuba.
Nihon Rinsho. 1992 May;50(5):1099-103.
Multiple trauma patients requiring prolonged intensive care are at high risk of MRSA infections. Surgical debridement and proper antibiotic prophylaxis combined with isolation of this compromised host from indigenous bacteria are the mainstays of initial therapy to prevent this complication. If this develops postoperatively, the sites of infection vary among the patients, such as urinary tract, surgical wounds, the abdomen, respiratory tract, vascular catheters, etc. Clinical evidence of sepsis suggests that intra-abdominal and respiratory tract infection are major contributors to mortality. In a postoperative multiple trauma patient, with pneumonia, thoracic empyema, intraabdominal abscess, wound infection and sepsis caused by MRSA, surgical drainage of the abscess with systemic infusion of vancomycin was effective and resulted in full recovery.
需要长期重症监护的多发伤患者发生耐甲氧西林金黄色葡萄球菌(MRSA)感染的风险很高。手术清创、适当的抗生素预防以及将这种免疫功能低下的宿主与天然细菌隔离开来是预防该并发症初始治疗的主要方法。如果在术后发生这种情况,感染部位在患者之间各不相同,如泌尿道、手术伤口、腹部、呼吸道、血管导管等。脓毒症的临床证据表明,腹腔内和呼吸道感染是导致死亡的主要因素。在一名术后多发伤患者中,由MRSA引起肺炎、胸腔积脓、腹腔脓肿、伤口感染和脓毒症,通过脓肿的手术引流并全身输注万古霉素是有效的,且患者完全康复。