临床医务人员鼻前庭金黄色葡萄球菌定植现况调查

Investigation on colonization of Staphylococcus aureus in nasal vestibule in clinical medical staff

目的了解医院临床科室医务人员鼻前庭金黄色葡萄球菌(包括甲氧西林敏感的金黄色葡萄球菌和耐甲氧西林的金黄色葡萄球菌)定植情况,并探讨影响金黄色葡萄球菌定植的主要因素,为临床干预提供科学依据。方法 2016年12月-2017年1月,研究人员对医院临床科室工龄≥1年的医务人员进行鼻前庭采样,根据MSSA检出排名分重点科室和普通科室;采样后对标本进行细菌学培养,金黄色葡萄球菌阳性标本使用头孢西丁纸片扩散法进一步判定是否为甲氧西林敏感的金黄色葡萄球菌(MSSA)或耐甲氧西林金黄色葡萄球菌(MRSA),收集数据使用SPSS 18.0统计软件进行统计分析。结果共调查11个临床科室,349名医务人员,采集标本349份,检出金黄色葡萄球菌18株,其中MSSA12株,医务人员人群定植率3.44%;MRSA6株,医务人员人群定植率1.72%;金黄色葡萄球菌的定植与医务人员年龄、性别、工龄、职业无关;重点科室医务人员鼻前庭的金黄色葡萄球(MSSA和MRSA)定植率均高于普通科室医务人员,差异有统计学意义(P<0.05)。结论金黄色葡萄球菌在医务人员鼻前庭定植率较低,重点科室医务人员鼻前庭的金黄色葡萄球菌特别是MRSA的定植需要关注。

OBJECTIVE To investigate the colonization of Staphylococcus aureus （methicillin-sensitive S. aureus and methicillin-resistant S. aureus） in clinical medical staff of our hospital, and to explore the main factors affect- ing the colonization of S. aureus, so as to provide a scientific basis for clinical intervention. METHODS The clini- cal medical staff（length of service≥1 year） from key departments and general departments in our hospital were sampled by nasal vestibule from Dec. 2016 to Jan. 2017 and the bacteria were cultured. S. aureus positive speci- mens were further identified whether methicillin-sensitive S. aureus（MSSA） or methicillin-resistant S. aureus （MRSA） using cefoxitin disk diffusion method. SPSS18.0 statistical software was used for statistical analysis. RESULTS A total of 11 clinical departments of 349 medical staff were surveyed, and 349 specimens were collected. Totally 18 S. aureus strains were detected, including 12 strains of MSSA, with population colonization rate of 3.44%, and 6 strains of MRSA, with population colonization rate of 1.72%. S. aureus colonization had nothing to do with age, gender, length of service, and occupation. The colonization rates in medical staff from the key de- partments were significantly higher than those from the general departments （P〈0.05）. CONCLUSION S. aureus colonization rate in the nasal vestibular of medical staff is low, the nasal vestibular S. aureus colonization（especial- ly MRSA） in medical staff from the key departments needs to bepaied attention.