Objective To analyze the drug resistance of Staphylococcus aureus (SA) isolated from blood sam-ples of patients with bloodstream infections (BSI) and the risk factors of methicillin-resistant SA (MRSA) .Methods Data of all SA strains isolated from blood of patients with BSI during 2009 and 2011 were retrospectively analyzed . Patients with BSI were divided into two groups ,including methicillin-sensitive SA (MSSA) infection group and MR-SA infection group ,and infection patients not caused by SA were enrolled as control group .The risk factors of MR-SA blood infection were analyzed .Results 289 strains of SA were isolated ,66 .90% (192/289) of which were MR-SA .Drug resistance of MRSA group was higher than the MSSA group .Morality rates of MRSA group and MSSA group were higher than control group ,but the difference between MRSA group and MSSA group was not signifi-cant .Logistic regression analysis indicated that ICU occupancy (>7 d) ,central venous catheter ,combined use of antibiotics and therapeutic time of antibiotics more than 2 weeks were the independent risk factors of BSI caused by MRSA .Conclusion The detectable rate and drug resistance rate of MRSA ,isolated from BSI patients caused by SA , might be extremely serious ,and the mortality of patients might be high .BSI caused by MRSA could be correlated with various independent rick factors ,which should be effectively controlled .%目的分析血液感染金黄色葡萄球菌耐药性及甲氧西林耐药株感染的危险因素。方法对本院2009～2011年金黄色葡萄球菌血液感染患者流行病学资料进行回顾性研究。将感染患者分为甲氧西林敏感（MSSA）组和耐药组（MRSA），然后采用1∶2成组病例对照方法选取同时期非金黄色葡萄球菌感染患者作为对照组，对M RS A血液感染危险因素进行分析。结果血液标本分离的289株金黄色葡萄球菌中192株为甲氧西林耐药株，占66．90％，MRSA组耐药性明显高于MSSA组。甲氧西林耐药组和敏感组感染患者的病死率均高于对照组，但是MRSA组与MSSA组病死率比较差异无统计学意义。Logistic回归分析显示，重症监护室（ICU）入住（＞7 d）、中心静脉置管、联合用药大于2种和抗生素使用时间大于2周是M RSA感染的独立危险因素。结论血液分离金黄色葡萄球菌MRSA株检出率高、耐药性强，患者的病死率高。MRSA血液感染具有多个独立危险因素，加强对这些独立危险因素的控制可有效预防其感染扩散。
展开▼
