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慢性鼻窦炎患者抗生素耐药性概况调查及耐甲氧西林感染影响因素的多方面分析。

Investigation into Antibiotic Resistance Profiles of Among Chronic Rhinosinusitis Patients and Multifaceted Analysis of Factors Influencing Methicillin-Resistant Infection.

作者信息

Liu Mingqiu, Sun Feng, Qi Yongli, Qi Wenjing, Li Junyi

机构信息

Department of Otolaryngology, Affiliated People's Hospital of Shandong First Medical University, Shandong, Jinan, People's Republic of China.

出版信息

Infect Drug Resist. 2025 Aug 27;18:4363-4371. doi: 10.2147/IDR.S546894. eCollection 2025.

Abstract

OBJECTIVE

This study aimed to comprehensively investigate the antibiotic resistance characteristics of in chronic rhinosinusitis (CRS) patients and to identify key determinants influencing the development of methicillin-resistant Staphylococcus aureus (MRSA) infections.

METHODS

A retrospective analysis was conducted on 180 CRS patients admitted to our hospital between February 2022 and July 2024. Nasal secretion samples were collected upon admission for strain isolation, and antibiotic susceptibility testing was performed using an automated microbiology system. Patients were categorized into MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) groups based on oxacillin resistance. Univariate analysis was used to screen potential risk factors, followed by multivariate logistic regression to determine independent predictors.

RESULTS

Among 180 isolated strains, 74 (41.1%) were MRSA and 106 (58.9%) were MSSA. MRSA strains exhibited significantly higher resistance rates to cefoxitin, amikacin, ciprofloxacin, and six other antibiotic classes compared to MSSA strains (all P<0.05), with resistance exceeding 50% for fluoroquinolones and macrolides. Univariate analysis identified 12 clinical factors associated with MRSA infection, including male sex, smoking history, disease duration >5 years, and frequent antibiotic use. Multivariate regression analysis confirmed nine independent risk factors: male sex (OR=2.31), nasal structural abnormalities (OR=1.89), previous nasal surgery (OR=1.76), ≥3 acute infections per year (OR=2.14), excessive antibiotic exposure, and others.

CONCLUSION

MRSA exhibits pronounced resistance to commonly used antibiotics in CRS treatment. Clinicians should prioritize targeted screening for high-risk patients, optimize antibiotic stewardship, and enhance postoperative nasal function management. Implementing a multifaceted approach-including early risk assessment, standardized antibiotic use, and intensified follow-up care-can effectively mitigate MRSA infection risks and improve overall treatment outcomes for CRS patients.

摘要

目的

本研究旨在全面调查慢性鼻-鼻窦炎(CRS)患者中[具体细菌名称未给出]的抗生素耐药特征,并确定影响耐甲氧西林金黄色葡萄球菌(MRSA)感染发生的关键决定因素。

方法

对2022年2月至2024年7月期间我院收治的180例CRS患者进行回顾性分析。入院时采集鼻分泌物样本进行[具体细菌名称未给出]菌株分离,并使用自动化微生物系统进行抗生素敏感性测试。根据对苯唑西林的耐药情况将患者分为MRSA组和甲氧西林敏感金黄色葡萄球菌(MSSA)组。采用单因素分析筛选潜在危险因素,随后进行多因素逻辑回归分析以确定独立预测因素。

结果

在180株分离出的[具体细菌名称未给出]菌株中,74株(41.1%)为MRSA,106株(58.9%)为MSSA。与MSSA菌株相比,MRSA菌株对头孢西丁、阿米卡星、环丙沙星和其他六种抗生素类别的耐药率显著更高(所有P<0.05),氟喹诺酮类和大环内酯类的耐药率超过50%。单因素分析确定了12个与MRSA感染相关的临床因素,包括男性、吸烟史、病程>5年和频繁使用抗生素。多因素回归分析确认了9个独立危险因素:男性(OR=2.31)、鼻腔结构异常(OR=1.89)、既往鼻部手术(OR=1.76)、每年≥3次急性感染(OR=2.14)、抗生素暴露过多等。

结论

MRSA对CRS治疗中常用抗生素表现出明显耐药。临床医生应优先对高危患者进行针对性筛查,优化抗生素管理,并加强术后鼻腔功能管理。采取多方面措施,包括早期风险评估、规范抗生素使用和强化随访护理,可有效降低MRSA感染风险,改善CRS患者的总体治疗效果。

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