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目的提高医务人员对耐甲氧西林金黄色葡萄球菌(MRSA)医院感染的认识,指导临床合理用药。方法调查2008年3-6月医院重症监护病房(ICU)发生伴有MRSA感染的死亡病例,分析2007年1月-2008年12月MRSA细菌谱及耐药情况。结果3例死亡病例均检出MRSA,药敏试验显示对万古霉素敏感,对其他抗菌药物耐药;2007年1月-2008年12月共检出MRSA 30株,药敏试验显示:对青霉素、红霉素、头孢唑林、苯唑西林耐药率达100.0%;对环丙沙星、克林霉素、左氧氟沙星、复方新诺明等耐药率为66.7%~87.0%。结论MRSA对抗菌药物耐药严重,易侵袭营养不良、大手术创伤、术后长时间使用呼吸机的患儿,应早期使用敏感药物,并从医院感染管理、医疗护理管理等多学科的角度,预防与控制MRSA医院感染暴发。
Objective To improve medical staff awareness of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infection and guide clinical rational drug use. Methods The deaths from hospital intensive care unit (ICU) from March to June 2008 with MRSA infection were investigated. The bacterial spectrum and drug resistance of MRSA from January 2007 to December 2008 were analyzed. Results MRSA was detected in all the 3 death cases. Susceptibility test showed that it was sensitive to vancomycin and resistant to other antibacterial drugs. From January 2007 to December 2008, MRSA was detected in 30 strains. Susceptibility test showed that the susceptibility to penicillin , Erythromycin, cefazolin, oxacillin resistance rate of 100.0%; ciprofloxacin, clindamycin, levofloxacin, cotrimoxazole resistance rate of 66.7% to 87.0%. Conclusions MRSA is resistant to antibacterial drugs, easy to attack malnutrition, major trauma, long-term use of ventilator after surgery, should be the early use of sensitive drugs, and from the hospital infection management, medical care management and other multidisciplinary perspective, Prevention and control of MRSA nosocomial infections.