万古霉素在成年耐甲氧西林金黄色葡萄球菌（MRSA）感染患者治疗中的应用：中国一家三级医院的调查
The use of vancomycin in the treatment of adult patients with methicillin-resistant Staphylococcus aureus (MRSA) infection: a survey in a tertiary hospital in China.
作者信息
Tang Jing, Hu Jiali, Kang Lei, Deng Zhengjun, Wu Jiaofen, Pan Jiaqian
机构信息
Department of Clinical Pharmacy, Shanghai First People's Hospital, Shanghai Jiao Tong University Shanghai 201620, PR China.
出版信息
Int J Clin Exp Med. 2015 Oct 15;8(10):19436-41. eCollection 2015.
BACKGROUND
Vancomycin is frequently used in the treatment of methicillin-resistant Staphylococcus aureus (MRSA).
OBJECTIVES
To determine MRSA infection status and the use of vancomycin in its treatment at a teaching hospital in China.
METHODS
We retrospectively reviewed 140 cases of MRSA infection that were treated from January 2013 to October 2014. We analyzed the etiology of MRSA infection and the use of vancomycin in these cases.
RESULTS
MRSA infection mainly occurred in elderly patients concomitant with a variety of diseases, which incidence was more in men than women. More cases of MRSA infection were encountered in the ICU than in other departments. The positive culture results for MRSA were obtained in the sputum (38.57%), pharyngeal swab (19.29%), blood (5.71%), and wound secretion (11.43%) samples. The MRSA patients were sensitive to vancomycin, with the minimum inhibitory concentration (MIC) being 1 μg/mL in 53.80% of the cases and 2 μg/mL in 44.10% of the cases, respectively. Among the 35 (25%) cases treated with vancomycin, 23 were cured, while 3 died and 7 (20%) were considered as an unreasonable application.
CONCLUSIONS
MRSA infection mainly appeared in patients admitted to the ICU. The MIC of vancomycin had a tendency to increase gradually.
背景
万古霉素常用于治疗耐甲氧西林金黄色葡萄球菌（MRSA）感染。
目的
确定中国一家教学医院的MRSA感染状况及其治疗中万古霉素的使用情况。
方法
我们回顾性分析了2013年1月至2014年10月期间接受治疗的140例MRSA感染病例。我们分析了这些病例中MRSA感染的病因以及万古霉素的使用情况。
结果
MRSA感染主要发生在伴有多种疾病的老年患者中，男性发病率高于女性。重症监护病房（ICU）的MRSA感染病例比其他科室更多。MRSA阳性培养结果在痰液（38.57%）、咽拭子（19.29%）、血液（5.71%）和伤口分泌物（11.43%）样本中获得。MRSA患者对万古霉素敏感，53.80%的病例最低抑菌浓度（MIC）为1μg/mL，44.10%的病例为2μg/mL。在35例（25%）接受万古霉素治疗的病例中，23例治愈，3例死亡，7例（20%）被认为使用不合理。
结论
MRSA感染主要出现在入住ICU的患者中。万古霉素的MIC有逐渐升高的趋势。
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