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[囊性纤维化患者中的耐甲氧西林金黄色葡萄球菌]

[Methicillin-resistant Staphylococcus aureus in patients with cystic fibrosis].

作者信息

Girón Rosa M, Buendía Buenaventura, Pinedo Celia, Casanova Alvaro, Hoyos Nieves, Ancochea Julio

机构信息

Servicio de Neumología, Hospital Universitario de la Princesa, Madrid, España.

出版信息

Enferm Infecc Microbiol Clin. 2009 Feb;27(2):85-8. doi: 10.1016/j.eimc.2008.02.008. Epub 2009 Feb 13.

Abstract

OBJECTIVE

To determine the prevalence of chronic colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients with cystic fibrosis, describe antibiotic sensitivity of the strains, and compare the patients' clinical characteristics with those of patients infected with methicillin-sensitive S. aureus (MSSA).

PATIENTS AND METHODS

Patients with chronic S. aureus colonization were selected from a total of 50 patients with cystic fibrosis. Sputum samples were cultured according to standard microbiological procedures. Patients were considered to have chronic bronchial colonization if the same microorganism was isolated in 3 consecutive sputum samples, separated by an interval of at least 1 month. The following variables were compared between patients with MSSA (17) and MRSA (8): sex, body mass index, presence of pancreatic insufficiency, bacterial colonization, pulmonary function, Brasfield radiological score, Shwachman clinical score, and number of respiratory exacerbations in the previous year.

RESULTS

The prevalence of infection by MRSA was 16%. All the MRSA strains were sensitive to vancomycin, teicoplanin, and linezolid. Patients with MRSA were older and had a larger number of respiratory exacerbations than patients with MSSA.

CONCLUSIONS

There is a high percentage of colonization by MRSA in adult cystic fibrosis patients. Although the pathogenic role of this microorganism remains unclear, patients with MRSA had more frequent exacerbations and poorer lung function. Thus, infection control is important and patients should be adequately monitored.

摘要

目的

确定囊性纤维化患者中耐甲氧西林金黄色葡萄球菌(MRSA)慢性定植的患病率,描述菌株的抗生素敏感性,并将患者的临床特征与甲氧西林敏感金黄色葡萄球菌(MSSA)感染患者的临床特征进行比较。

患者与方法

从总共50例囊性纤维化患者中选取慢性金黄色葡萄球菌定植患者。痰液样本按照标准微生物学程序进行培养。如果在至少间隔1个月的连续3份痰液样本中分离出相同微生物,则患者被认为患有慢性支气管定植。比较了MSSA患者(17例)和MRSA患者(8例)之间的以下变量:性别、体重指数、胰腺功能不全的存在情况、细菌定植、肺功能、布拉斯菲尔德放射学评分、施瓦克曼临床评分以及上一年的呼吸道加重次数。

结果

MRSA感染的患病率为16%。所有MRSA菌株对万古霉素、替考拉宁和利奈唑胺敏感。与MSSA患者相比,MRSA患者年龄更大,呼吸道加重次数更多。

结论

成年囊性纤维化患者中MRSA定植的比例很高。尽管这种微生物的致病作用仍不清楚,但MRSA患者病情加重更频繁,肺功能更差。因此,感染控制很重要,应对患者进行充分监测。

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