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耐甲氧西林金黄色葡萄球菌(MRSA)感染的临床分析

[Clinical analysis of methicillin-resistant Staphylococcus aureus (MRSA) infection].

作者信息

Takezawa Y, Ohtake N, Okamura K, Shibata Y, Nakano K, Yamanaka H

机构信息

Department of Urology, Tone Chuo Hospital.

出版信息

Hinyokika Kiyo. 1994 Nov;40(11):999-1003.

PMID:7832086
Abstract

In 14 patients from which methicillin-resistant Staphylococcus aureus (MRSA) was isolated at the Department of Urology, Tone Chuo Hospital June, 1992 and October, 1993, the site of infection, background of patients, and drug resistance were analyzed. The 14 patients consisted of 11 males and 3 females between 45 and 85 years old with a mean of 71.6 years. The site from which MRSA was isolated was urine in 11, wound in 2, nasal cavity in 1, pharynx in 1, and renal fistula in 1 (detected at 2 or more sites in 2). The underlying condition was prostate hyperplasia in 2, prostate cancer in 4 (after radical prostatectomy in 1, complicated by bladder stone in 1), bladder tumor in 3, (during bladder instillation of BCG in 1), perirenal abscess in 2, renal pelvic tumor in 1, neurogenic bladder in 1, and after Boari's operation in 1. Urethral catheterization had been performed in 3. A fewer of 38 degrees C or above was noted in 3. Mixed infection was observed in 10, and was caused by Escherichia coli in 2, Proteus mirabiris in 1, Candida in 1, Klebsiella in 2, Pseudomonas aeruginosa in 2, and Serratia in 2. Four patients has previously been administered antibiotics, which were third generation cephems in 3 and penicillin in 1. The drug sensitivity was 100% for vancomycin (VCM), 30% for imipenam (IMP), 31% for minomycin (MINO), 31% for amikacin (AMK), and 7% for fosfomycin (FOM). As for chemotherapy, VCM+FOM+sulbactam/cefoperazone were administered to 6, and ceftazidime+ MINO were administered to 1.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1992年6月至1993年10月期间,在丰洲中央医院泌尿外科分离出耐甲氧西林金黄色葡萄球菌(MRSA)的14例患者中,对感染部位、患者背景及耐药性进行了分析。这14例患者包括11名男性和3名女性,年龄在45岁至85岁之间,平均年龄为71.6岁。分离出MRSA的部位为:尿液11例、伤口2例、鼻腔1例、咽部1例、肾瘘1例(2例在2个或更多部位检测到)。基础疾病为:前列腺增生2例、前列腺癌4例(1例为根治性前列腺切除术后,1例合并膀胱结石)、膀胱肿瘤3例(1例在膀胱灌注卡介苗期间)、肾周脓肿2例、肾盂肿瘤1例、神经源性膀胱1例、1例在施行鲍里手术之后。3例曾行导尿术。3例体温在38摄氏度及以上。10例观察到混合感染,其中由大肠杆菌引起2例、奇异变形杆菌1例、念珠菌1例、克雷伯菌2例、铜绿假单胞菌2例、沙雷菌2例。4例患者此前曾使用过抗生素,其中3例使用第三代头孢菌素,1例使用青霉素。万古霉素(VCM)的药敏率为100%,亚胺培南(IMP)为30%,米诺环素(MINO)为31%,阿米卡星(AMK)为31%,磷霉素(FOM)为7%。化疗方面,6例给予VCM+FOM+舒巴坦/头孢哌酮,1例给予头孢他啶+MINO。(摘要截选至250词)

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