血流感染耐甲氧西林金黄色葡萄球菌对患者预后的影响

摘要

Objective To understand the impact of methicillin-resistant Staphylococcus aureus (MRSA)blood-stream infection on the length of hospital stay,hospital mortality,and poor prognosis of patients.Methods 357 patients with Staphylococcus aureus (S .aureus)bacteremia in a hospital between January 1 ,2009 and December 31 , 2013 were surveyed and analyzed retrospectively.Results Of 357 patients,91 were infected with MRSA and 266 with methicillin-susceptible S .aureus (MSSA).The length of hospital stay was statistically different between MR-SA and MSSA group(29 d vs 23 d,P <0.01);before infection,length of hospital stay of MRSA group was longer than MSSA group(P <0.01 );after infection,length of hospital stay was not statistically different between two groups(17 d vs 16.5 d,P = 0.92 ).Mortality of MRSA group and MSSA group was not statistically different (13.19% vs 9.02%,χ2 =1 .28,P =0.26).The incidence of poor prognosis of MRSA group was higher than MSSA group(29.67% vs 16.92%,χ2 =6.85,P =0.01 ).Multivariate analysis results showed that MRSA infection was independent risk factor for poor prognosis (P <0.01).Conclusion MRSA infection doesn’t contribute to the pro-longation of hospital stay,but MRSA bloodstream infection is a risk factor for poor prognosis of patients.%目的：了解耐甲氧西林金黄色葡萄球菌（MRSA）感染对患者住院时间、院内死亡以及不良预后的影响。方法对2009年1月1日—2013年12月31日华西医院血培养确诊为金黄色葡萄球菌感染的357例住院患者进行回顾性调查分析。结果357例患者，MRSA 感染91例，甲氧西林敏感金黄色葡萄球菌（MSSA）感染266例。MRSA 组和 MSSA 组住院时间比较（29 d vs 23 d），差异有统计学意义（P ＜0．01）；感染前 MRSA 组患者住院时间长于 MSSA 组（P ＜0．01），感染后两组患者住院时间比较（17 d vs 16．5 d），差异无统计学意义（P ＝0．92）。MRSA 组和 MSSA 组患者死亡率比较（13．19％ vs 9．02％），差异无统计学意义（χ2＝1．28，P ＝0．26）；MRSA 组不良预后发生率为29．67％，高于 MSSA 组的16．92％（χ2＝6．85，P ＝0．01）。多因素分析结果显示，MRSA 感染是患者预后不良的独立危险因素（P ＜0．01）。结论MRSA 感染未增加患者住院时间，但 MRSA 血流感染是患者不良预后的危险因素。