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[葡萄球菌感染作为重症治疗中的一个重要问题——自身临床观察]

[Staphylococcal infections as an important problem in intensive therapy--own clinical observations].

作者信息

Czaban Sławomir Lech, Olszańska Dorota, Siemiatkowski Andrzej

机构信息

Klinika Anestezjologii i Intensywnej Terapii, Akademii Medycznej w Białymstoku, Kierownik.

出版信息

Przegl Lek. 2006;63(7):529-32.

Abstract

The microbiological monitoring in the Intensive Care Units, in the last few years, revealed a significant increase of infections caused by Gram+ bacteria. Authors of multi-center studies focus upon the problems related to the treatment of the infections caused by the methicilline-resistant staphylococci (MRS) as well as to its spreading. The Staphylococcal infections were 26.6 % of all bacterial infections in the Intensive Care Unit of the Department of Anesthesiology and Intensive Care of the Medical Academy in Białystok, during one year observation. MRS rods counted 21.4% among all pathogens isolated from the specimens collected from the patients, undergoing the treatment in the ICU, and were responsible for 83.6% of all Staphylococcal infections. The analysis revealed the significant percentage MRS rods resistant to commonly used empirical antibiotic therapy. Our experience shows that vancomycin or linezolid should be used, as an empirical antibiotic therapy, in suspected MRS-caused severe infections along with the simultaneous monitoring of changes in G+ bacteria drug resistance and strict infection-control regime.

摘要

在过去几年中,重症监护病房的微生物监测显示,革兰氏阳性菌引起的感染显著增加。多中心研究的作者关注与耐甲氧西林葡萄球菌(MRS)引起的感染治疗及其传播相关的问题。在比亚韦斯托克医学院麻醉学和重症监护科重症监护病房进行的一年观察期间,葡萄球菌感染占所有细菌感染的26.6%。在从重症监护病房接受治疗的患者采集的标本中分离出的所有病原体中,耐甲氧西林葡萄球菌占21.4%,并导致了所有葡萄球菌感染的83.6%。分析显示,耐甲氧西林葡萄球菌对常用经验性抗生素治疗耐药的比例很高。我们的经验表明,在怀疑由耐甲氧西林葡萄球菌引起的严重感染时,应使用万古霉素或利奈唑胺作为经验性抗生素治疗,同时监测革兰氏阳性菌耐药性的变化并实施严格的感染控制制度。

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