社区获得性和医院获得性MRSA感染的差异

摘要

Objective To realize the characteristics and drug resistance of community-associated(CA) and healthcare-associated (HA) methicillin-resistant Staphylococcus aureus (MRSA) infection, and provide reference for the prevention and control of MRSA infection. Methods Data of MRSA-infected patients who were hospitalized between January and June 2010 were reviewed and analyzed retrospectively. Results The major CA-MRSA infection site was skin and soft tissue (58. 82%). The rate of CA-MRSA respiratory tract infection and HA-MRSA respiratory tract infection was 29. 41% and 29. 63% respectively. There was significant difference in age, length of hospital stay, ICU stay, surgical operation and invasive operation between CA-MRSA and HA-MRSA infected patients(P< 0. 05). The resistant rate of HA-MRSA to rifampicin, gentamicin, moxifloxacin, and ciprofloxacin were all higher than those of CA-MRSA (74. 19% - 93. 33% vs 37. 50% - 52. 94%, P<0. 05). Conclusion CA-MRSA infection varies from HA-MRSA infection in infection characteristics and drug resistance, prevention and control measures should be strengthened, and antimicrobial agents should be used according to antimicrobial susceptibility testing result.%目的 了解某医院社区获得性和医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)感染的特点及耐药性,为MRSA感染的预防控制与治疗提供依据.方法 采用前瞻性调查方法,对2010年1-6月该院MRSA感染者资料进行调查和统计分析.结果 社区获得性MRSA(CA-MRSA)感染部位以皮肤软组织为主,占58.82%.MRSA呼吸道感染在社区和医院感染中的比例均较高,分别为29.41%和29.63%.CA-MRSA与医院获得性MRSA(HA-MRSA)感染者在年龄、住院天数、是否住重症监护室、是否手术、侵入性操作等方面存在明显差异(P＜0.05).HA-MRSA对利福平、庆大霉素、莫西沙星、环丙沙星的耐药率(74.19%～93.33%)显著高于CA-MRSA(37.50%～52.94%)(P＜0.05).结论 CA-MRSA 与HA-MRSA感染特点及耐药性存在差异,应加强监测和防控,根据药敏试验结果 合理使用抗菌药物.