一起耐甲氧西林金黄色葡萄球菌医院感染的调查

Epidemiologic Study of One Meticill-Resistant Staphylococcus aureus Nosocomial Infection in Burn Ward

目的分析一起耐甲氧西林金黄色葡萄球菌医院感染的危险因素,探索有效的控制措施。方法查看病房环境、回归性病例分析,利用PFGE方法对耐甲氧西林金黄色葡萄球菌(MRSA)菌株进行同源性分析。结果2007年6～7月MRSA感染9例,罹患率为15%;病房分布有聚集性;9份菌株药敏结果基本相同;5份菌株具有高度同源性;主要的危险因素有抗菌素的频繁使用、大面积的烧伤、与感染者同房、换床、陪护和探视等。结论合理使用抗生素,尽量减少侵袭性操作、严格隔离MRSA感染者、严格控制人员尤其探视人员进入、加强医护人员的手部卫生、加强器械及环境消毒、及时采样送检是预防和控制MRSA感染的关键。

Objective Investigate the Meticill Resistant Staphylococcus aureus nosocomial infection in order to determine the risk factors, explore control measures and prevention. Methods The investigation was conducted by reviewing the records of bacteria culture and cases, visiting doctors and nurses, and analyzing the homology of MRSA strains by PFGE. Results 9 cases were identified during June and July, with an incident rate of 15% and the distribution appeared ward clustering. All the strains had a similar result of drug sensitive test. These strains have high homology with each other. Using antibiotics frequently, extensive deep bums, living with the infection of MRSA, with accompany and visitors were the major risk factors of MRSA infection. Conclusion Reasonable usage of antibiotics, avoid invasive operation, straightly quarantine of MRSA patients, straightly control the number of visitors, enforce the hand hygiene of health-care staff, enforce the decontamination of equipments and the environment, promptly sending samples for test are the most critical factors for control and prevent MRSA nosocomial infection.