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目的了解金黄色葡萄球菌(SA)致晚期肺癌患者下呼吸道感染的临床与耐药特征,为临床合理用药提供参考依据。方法收集金华市人民医院2009年12月至2014年11月住院治疗晚期肺癌患者发生下呼吸道感染的送检标本,应用法国生物梅里埃Vitek 2-Compact全自动微生物鉴定仪鉴定菌种,药敏试验采用纸片法(K-B)进行。结果157株SA中耐甲氧西林金黄色葡萄球菌(MRSA)98株,占62.4%,药敏试验表明MRSA对青霉素G、红霉素、四环素、头孢西丁、莫西沙星100.0%耐药,对β-内酰胺类、喹诺酮类、大环内酯类、氨基糖苷类、磺胺类抗菌药物耐药率均较高(26.5%~93.9%),且存在多药耐药,MRSA耐药率普遍高于MSSA,差异有统计学意义(P<0.05)。结论从晚期肺癌患者合并下呼吸道感染患者中分离出的金黄色葡萄球菌以MRSA为主,MRSA较MSSA的耐药性高,而且多重耐药严重,临床必须加强金黄色葡萄球菌感染的监控,并根据药敏试验结果合理选用抗菌药物。
Objective To understand the clinical and drug resistance characteristics of lower respiratory tract infection in patients with advanced lung cancer caused by Staphylococcus aureus (SA), and to provide a reference for clinical rational drug use. Methods The specimens of lower respiratory tract infection in hospitalized patients with advanced lung cancer admitted from December 2009 to November 2014 in Jinhua People’s Hospital were collected and the strains were identified by the Vitek 2-Compact Microbial Identification System Using paper method (KB). Results A total of 98 strains of methicillin-resistant Staphylococcus aureus (MRSA) were found in 157 isolates of SA, accounting for 62.4% of the total isolates. Susceptibility tests showed that MRSA was 100.0% resistant to penicillin G, erythromycin, tetracycline, cefoxitin and moxifloxacin, The resistance rates of β-lactams, quinolones, macrolides, aminoglycosides and sulfonamides were all high (26.5% -93.9%), and there was multi-drug resistance and MRSA resistance was common Higher than MSSA, the difference was statistically significant (P <0.05). Conclusion Staphylococcus aureus isolated from patients with advanced lung cancer complicated with lower respiratory tract infection is mainly MRSA. MRSA is more resistant than MSSA and has multi-drug resistance. It is necessary to strengthen the surveillance of Staphylococcus aureus infection According to drug susceptibility test results reasonable selection of antimicrobial agents.