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目的探讨社区获得性耐甲氧西林金黄色葡萄球菌(MRSA)下呼吸道感染的临床特征、诊断与治疗。方法回顾性分析焦作市人民医院呼吸内科收治的6例社区获得性MRSA下呼吸道感染患者的临床资料。结果 6例患者均好转出院,随访3个月,1例出现肺部结构及功能受损,余无复发及不适。结论社区获得性MRSA下呼吸道感染不具备医院获得性MRSA感染的高危因素,见于免疫功能正常的青年及老年人,也可见于合并糖尿病等患者,CT具有坏死性肺炎的特征,可形成肺脓肿甚至脓气胸,糖肽类抗生素或利奈唑胺治疗有效,联合克林霉素或许能使患者受益。
Objective To investigate the clinical characteristics, diagnosis and treatment of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) lower respiratory tract infection. Methods The clinical data of 6 patients with community-acquired lower respiratory tract infection of MRSA admitted to Department of Respiratory Medicine, Jiaozuo People’s Hospital were retrospectively analyzed. Results All 6 patients were well discharged and were followed up for 3 months. One patient had impaired lung structure and function, and no recurrence or discomfort. Conclusions The community-acquired lower respiratory tract infections of MRSA do not have the risk factors of hospital-acquired MRSA infection. They are found in young and elderly patients with normal immune function and also in patients with diabetes mellitus. CT has the characteristics of necrotizing pneumonia and can form pulmonary abscess and even Pus pneumothorax, glycopeptide antibiotics or linezolid treatment of effective, combined with clindamycin may benefit the patient.