[シンポジウム]消化器外科手術後におけるメチシリン耐性黄色ブドウ球菌感染症例の検討

概要

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[Objective] Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common cause of nosocomical infections. The purpose of this study was to investigate prognostic factors of the postoperative MRSA infection in gastrointestinal surgery. [Materials and Methods] The clinical strains of MRSA were detected from 46 (40 men and 6 wemen) out of 1869 patients who were hospitalized in Department of surgery 1, University of the Ryukyus during January 1989 and July 1993. [Results] Twenty two patients died and 24 patients recovered. In this series, 40 patients (87% ) recieved gastrointestinal surgery for malignant diseases. Four patients died of the causes directly related to the postoperative MRSA infection. Two of these patients died of sepsis with anastmotic leakage and other two, MRSA pneumonia. MRSA strains were detected from only pharyngeal culture at initial stage, however, the local infection developed MRSA pneumonia in proportion as the general states of patients becoming worse. [Conclusion] The postoperative MRSA infections were originated from compromised hosts such as the patients with intractable complications following major invasive surgery for malignant disease.