金黄色葡萄球菌医院感染危险因素的研究

Nosocomial Infection Caused by Staphylococcus aureus:A Risk Factor Study

目的 为了解金黄色葡萄球菌医院感染的危险因素 ,防止金黄色葡萄球菌医院感染。方法 调查广州市 3所综合性医院住院患者金黄色葡萄球菌感染的临床资料 ,按 1∶ 1病例 -对照配比原则 ,对 14个危险因素进行L ogistic多元回归分析。结果 3所医院共检出金黄色葡萄球菌 2 2 6株 ,社区感染金黄色葡萄球菌 118株 ,其中MRSA4 5株 ,MSSA73株 ;确定为医院感染的金黄色葡萄球菌 10 8株 ,医院感染的 MRSA6 4株 ;MSSA4 4株 ,经χ2检验 (P<0 .0 5 )显示医院感染 MRSA所占的比例高于社区感染 ;医院感染多发生于呼吸内科、神经内科、神经外科及 ICU病房 ;常见的感染部位包括呼吸道 ,其次为手术切口、血液感染和皮肤感染 ,医院感染主要的危险因素包括使用呼吸机、感染前发生其他医院感染、使用多种抗生素、住 ICU病房。结论 合理使用抗生素 ,加强重点科室的监测 ,采取有效的消毒隔离措施是控制金黄色葡萄球菌医院感染的关键。

OBJECTIVE To determine the risk factors of nosocomial infection for S.aureus in three hospitals.METHODS An epidemiology investigation was studied. Case was reviewed with S.aureus infection patients, Logistic regression analysis was done with 1∶1 case control method. RESULTS The ratio of MRSA in nosocomial infection was significantly greater than of other community infection. Respiration Department,Neurological Department,Neurosurgery Department and ICU were easier occur S.aureus nosocomial infection.Major nosocomial infection sites included:lower respiratory tract,surgery wound,blood and skin.Major risk factors were related to nosocomial infection including:1. respiratory machine indwelling related infections;2. prior acquired infection;3.treatment of more antibiotics;4.the duration of ICU.CONCLUSIONS Rational use of antibiotics,making frequent main department nosocomial surveillance,effective sterilization and isolation measure were sticking points for control of S.aureus nosocomial infection.