The treatment of elderly patients with pulmonary infections caused by methicillin-resistance Staphylococcus aureus in intensive care unit

Abstract

Objective To compare the efficacy, bacterial clearance and adverse reactions of three kinds of anti-methicillin-resistanceStaphylococcus aureus(MRSA) drugs on the treatment of elderly pulmonary infection caused by MRSA in intensive care unit (ICU). Methods Total of 114 elderly patients with pulmonary infection caused by MRSA in ICU from March 2015 to May 2017 in Qingdao Central Hospital were selected, and were divided into vancomycin group, teicoplanin group, and linezolid group according to the drugs, 38 cases in each group. The treatment effect, bacterial clearance rate, serum C-reactive protein (CRP), procalcitonin (PCT), count of WBC, neutrophil ratio and adverse reactions were compared, respectively among the three groups. Results The clinical total effective rate of linezolid group was better than that of vancomycin group and teicoplanin group (χ2= 7.018,P = 0.008;χ2= 4.070,P= 0.044). The bacterial clearance rate of linezolid group was significantly higher than that of vancomycin group and teicoplanin group (χ2= 5.182,P= 0.023;χ2= 4.211,P = 0.040). After treatment, CRP, PCT, count of WBC and neutrophil ratio in each group were significantly lower than those before treatment, and the levels of CRP, PCT, count of WBC and neutrophil ratio in linezolid group were significantly lower than those of vancomycin group and teicoplanin group, with significant differences (allP< 0.05). Nausea, vomiting, liver dysfunction, kidney toxicity, abnormal serum creatinine, thrombocytopenia and anemia occurred in the three groups after treatment, with no significant difference in total incidence of adverse reactions among the three groups (χ2= 0.647,P= 0.723). Conclusions In the treatment of elderly patients with pulmonary infection casused by MRSA in ICU, linezolid is superior to vancomycin and teicoplanin in clinical efficacy and bacterial clearance, and its clinical safety is comparable. It is an ideal choice for the treatment of pulmonary infection casused by MRSA. Key words: Methicillin-resistantStaphylococcus aureus; Lung infection; Curative effect; Bacterial clearance rate; Adverse reaction