凝固酶阴性葡萄球菌菌血症临床感染特征及耐药性分析

摘要

Objective To investigate the clinical characteristics of patients with coagulase-negative staphylococci (CNS) bactere-mia and the drug resistance of isolates to provide basis for clinical diagnosis and treatment. Methods Medical records between Nov. 2009 and Oct. 2011 of 56 cases with CNS-induced bacteremia in this hospital were retrospectively analyzed. Results All of the cases were with fever and leukocytosis,treatment of a variety of catheter, pre-used antibiotics and positive blood culture alarm time less than 48 hours. Of the 56 strains of CNS,82. 5% were methicillin-resistant coagulase-negative the staphylococci(MRCNS) with rel-atively high sensitivity to vancomycin, teicoplanin and rifampin. The clinical treatment efficiency was 57. 1% and the mortality rate was 10. 7%. Conclusion CNS might be an important pathogen of bloodstream infections. To identify whether CNS is pathogen might be the key for clinical diagnosis. Vancomycin could still be preferred for the treatment of MRCNS bloodstream infection.%目的 分析凝固酶阴性葡萄球菌(CNS)菌血症患者临床资料及菌株耐药性,为临床诊断与治疗提供依据.方法 对该院2009年11月至2011年10月56例CNS菌血症患者临床资料进行回顾性统计分析.结果 CNS患者均有发热和白细胞升高、植入各种留置导管、先期使用过抗菌药物、血培养阳性报警时间小于48 h;56株CNS中,82.5%为甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS),对万古霉素、替考拉宁、利福平较为敏感;临床治疗有效率57.1%、死亡率10.7%.结论 CNS已是菌血症的重要病原菌,正确鉴定CNS是否为病原菌是临床诊断的关键,万古霉素仍是治疗MRCNS菌血症首选药物.