耐甲氧西林金黄色葡萄球菌引起的小肠结肠炎——附2例报告

D Yoshida, H Fukunari, I Hojo, K Kitago, M Ito, Z Nihei, T Inoue, Y Mishima
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摘要

本文报告2例胃切除术后因耐甲氧西林金黄色葡萄球菌(MRSA)引起的小肠结肠炎。病例1:59岁男性,因晚期胃癌行胃大部切除术。第一次手术后出现弥漫性腹膜炎,需再次手术引流。第二次手术两天后,她出现了严重的水样腹泻。病例2:46岁男性,因早期胃癌行全胃切除术。术后第四天,患者开始频繁呕吐和霍乱样腹泻,数小时后出现深度休克。两例均经万古霉素治疗成功。两例患者粪便培养均检出MRSA,且其最低抑菌浓度、凝固酶型和肠毒素型相同,提示医院感染。
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Enterocolitis due to methicillin-resistant Staphylococcus aureus--report of two cases.

Two cases of postoperative enterocolitis due to methicillin-resistant Staphylococcus aureus (MRSA) after gastrectomy were experienced. Case 1: A 59-year-old male underwent subtotal gastrectomy for advanced gastric cancer. Diffuse peritonitis progressed after the first operation, so reoperation for drainage was required. Two days after the second operation, a profuse watery diarrhea developed. Case 2: A 46-year-old male underwent total gastrectomy for early gastric cancer. On the fourth postoperative day, frequent vomiting and cholera-like diarrhea started, followed by profound shock several hours later. Both cases were treated successfully by the administration of vancomycin. Stool cultures of both cases revealed MRSA and it had the same minimal inhibitory concentration, coagulase type and enterotoxin type, so that nosocomial infection was indicated.

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