住院患儿耐甲氧西林金黄色葡萄球菌感染现状分析

Analysis of current condition of infection of methicillin-resistant Staphylococcus aureus in hospitalized children

目的分析医院耐甲氧西林金黄色葡萄球菌(MRSA)的感染分布及危险因素,为有效预防与控制MRSA医院感染提供依据。方法对2011年1月1日-12月31日住院患儿送检标本中分离的1007株金黄色葡萄球菌进行了MRSA感染监测,并对临床感染资料进行统计分析。结果住院患儿送检标本中共分离出MRSA 115株,分离率为11.42%;MRSA标本来源于下呼吸道68株、外科伤口41株,分别占59.13%、35.65%;MRSA感染患儿主要分布在新生儿外科、新生儿内科、重症医学科,分别占13.04%、11.30%、11.30%。结论免疫功能低下、皮肤受损、接受手术、使用侵入性操作、住院时间长以及抗菌药物不合理应用是发生MRSA感染的主要危险因素;加强高危科室、高危人群、重点部位的监测,减少危险因素的发生,可预防和减少MRSA的产生,控制医院感染。

OBJECTIVE To analyze the distribution and risk factors of methicillin-resistant Staphylococcus aureus （MRSA）, so as to provide the basis for effective prevention and control of MRSA nosocomial infections. METHODS A total of 1007 S. aureus isolated from clinical samples of hospitalized children from Jan. 1 to Dec. 31, 2011 were monitored for MRSA infection, and the clinical infection data were statistically analyzed. RESULTS A total of 115 strains of MRSA were isolated in the samples of hospitalized children, with the isolation rate of 11.42% 68 strains of MRSA mainly came from lower respiratory tract, and 41 strains came from surgical wounds, which accounted for 59.13%, 35.65% respectively; the children with MRSA infection were mainly in neonatal surgery, neonatal medicine, and intensive care unit, which accounted for 13, 04%, 11.30%, 11, 30%, respectively. CONCLUSION Immune dysfunction, skin damage, surgery, and the use of invasive procedures, long hospital stay and the irrational use of antimicrobial drugs are the major risk factors for MRSA infection. MRSA nosocomial infection can be prevented, reduced and controlled by strengthening the monitor of high-risk sections, high-risk population and intensive care sites as well as reducing the patients exposure to risk factors.