重症监护病房患者MRSA定植情况及影响因素研究

Study on colonization status and risk factors of methicillin resistant Staphylococcus aureus in patients of intense care units

目的研究耐甲氧西林金黄色葡萄球菌(MRSA)在重症监护病房(ICU)患者鼻腔携带定植情况及其影响因素。方法通过回顾性分析方法,对某医院ICU住院患者鼻腔棉拭子标本的检测结果进行调查与分析。结果2009年7月1日至2010年6月30日期间,该医院检测ICU入院24 h内623例患者鼻腔棉拭子标本检测结果,检出90例MRSA定植阳性,阳性率为14.45%。单因素分析发现,患者高龄、糖尿病、急性肾衰、充血性心衰、近期手术等为MRSA定植的危险因素。多因素分析发现,糖尿病及充血性心衰为ICU病人MRSA定植的独立危险因素。结论该医院ICU入院24 h内的病人鼻腔携带MRSA者占14.45%,这种MRSA定植构成多重耐药感染主要危险因素,抵抗力低下人群是MRSA定植的独立危险因素。

Objective To study colonization status and risk factors of methicillin resistant Staphylococcus aurues （MRSA） among patients＇ nasal in intense care unites （ICU）. Methods Retrospective investigation wa~ used to analyze the results of Nasal swabs samples of patients in ICU. Results Nasal swabs of 623 patients in admission ICU 24 h from Jul 1 st 2009 to Jun 30th 2010 lyzed, and 90 patients carried MRSA, the positive rate was 14. 45%. The univariate analysis found that the advanced age, diabetes mellitus, acute renal failure, congestive heart failure and recent surgery were risk factors for MRSA colonization. The multiple analysis found that diabetes mellitus and congestive heart failure were independent risk factors for MRSA colonization in ICU patients. Conclusion In patients admitted to ICU within 24 h, those with MRSA na- sal colonization accounted for 14. 45%. MRSA colonization was the major risk factor for multi - drug resistant infection, and low resistant patients was the independent risk factor of MRSA colonization.