我院医务人员手部葡萄球菌携带调查及增多原因分析

STUDY OF INCREASED STAPHYLOCOCCU IN MEDICAL STAFF'S HAND IN OUR HOSPTIAL

目的调查我院医务人员手部葡萄球菌携带情况，查明其增多原因。方法将医务人员手部携带的部分金黄色葡萄球菌、凝固酶阴性葡萄球菌做了“８４”消毒剂定性杀菌试验、ＭＩＣ检测、β－内酰胺酶、耐甲氧西林检测，抗菌药物耐药谱、质粒酶切谱分型。结果发现我院医务人员手部金黄葡萄球菌、葡萄球菌携带率已分别从１９９２年的８７０％（１０／１１５）、３２１７％（３７／１１５）上升至１９９７年的３４０６％（７８／２２９）、６５９４％（１５１／２２９），且７７９７％的菌株为ＭＲＳＡ（或ＭＲＣＮＳ），各科室之间无同源菌株。全部试验菌株在“８４”消毒剂有效氯的含量为１００ｐｐｍ浓度时，１分钟内可将其全部杀灭。结论我院医务人员手部葡萄球菌及金黄色葡萄球菌逐年上升的因素为：①长时间使用“８４”消毒剂，导致了部分菌株对“８４”消毒剂敏感性降低；②医务人员不常洗手；③采用“８４”消毒剂洗手致手部粗糙，难以洗净。

objective To investigate the cause of increased staphylococcus of medical staff's hands in our hospital. method staphylcoccus aurease,coagulase negative staphylococcus of medical staff's hands were tested by 84disinfectant gualitative bactericidal testMIC testdection of -lactmasemethicillin-resistant antibiotic resistant patternplasmid fringpriting pattern. results The rates of staphylococcus aureas and staphylococcus carry in hand increased from 870%(10/115)3217%(37/115) in 1992 to 3406%(78/229)6594%(151/229) in 1997 respectively, and 7797% strains are MRSA (MRCNS), no homogeueous stains exist among medical unit. All tested strains can be killed whithin 1 minute when effective chloride of 84 disinfectant is 100 ppm. conclusions The factor contribute to the increased staphylococcus aureas and staphylococcus of medical staff's hands are 1 Over-time use of 84 disinfectant result in the decreased suspectifility of disinfectant; 2 Medical staffs did not often wash their hands; 3 84 disinfectant result