手术室医务人员携带细菌情况的现状分析

Bacteria Carried Status Analysis on Medical Staff Working in Operating Room

目的 :观察手术室医务人员鼻前庭、双手屈掌面及手机携带细菌情况,为中医药防治细菌感染提供依据。方法 :采用涂抹采样和细菌分离鉴定法,对本院手术室工作1年以上的80例医护人员鼻前庭、双手屈掌面及手机所携带的病原菌进行培养。结果:80份医务人员鼻前庭标本共培养出致病菌112株,携带率100%(80/80),其中35.0%(28/80)的标本分离出2株及以上致病菌。在检出的112株致病菌中,革兰氏阳性球菌检出的前3位分别是表皮葡萄球菌、金黄色葡萄球菌和溶血性葡萄球菌。革兰氏阴性球菌检出的前3位分别是肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌。80份医务人员鼻前庭标本中,25份检出MRSA、MRSCON、ESBLs菌,携带率31.3%,检出MRSA、MRSCON、ESBLs菌35株,以MRSCON菌为主,占57.1%(20/35)。医生组手细菌检测合格率85.0%,护士组手细菌检测合格率93.3%,均高于护工组的53.3%(P<0.05)。80部手机标本中,仅1位护工的手机检测出细菌18 cfu/m L,超出合格标准。结论:本院手术室医护人员鼻前庭普遍携带致病菌,并存在多重耐药现象,护工手细菌感染率较高。应结合中医辨证,提早进行预防与调理。

Objective. To observe the status that medical staff in operating room carry bacteria on nasal vestibule, flexed hands and mobile phones, so as to provide reference for the prevention and treatment of Chinese medicine in treating bacterial infection. Methods： Both swabbing sampling and bacteria isolation and identification were used to cultivate and determine pathogen in nasal vestibule, flexed hands and mobile phones of 80 cases of medical staff who had been working in operating room for more than one year in our hospital. Results.. A total of 112 strains of pathogenic bacteria were cultivated in nasal vestibule of 80 medical staff, with a carrier rate of 100% （80/80）. Among them, 35% （28/80） of the samples isolated 2 strains and above. Among the 112 pathogens detected, the first three of Gram-positive cocci were Staphylococcus epidermidis, staphylococcus aureus and staphylococcus haemolyticus. And the first three of gram-negative cocci were klebsiella pneumonia, escherichia coil and enterobacter cloacae. Twenty-five specimens were dectedt with methicillin-resistant staphylococcus aureus （MRSA）, oxacillin resistant coagulase negative staphylococci （MRSCON） and extended spectrum beta-lactamases （ESBLs）, carrier rate being 31.3% ; 50 strains of MRSA, MRSCON and ESBLs were detected, with MRSCON accounting for 57.1% （20/35）. The qualified rate of hand bacteria was 85.0% in the doctor group and 93.3% in the nurse group, which was higher than 53.3% in the nursing group （P 〈0.05）. Of the 80 specimens of mobile phones, only one nurse＇s mobile phone was detected with 18 cfu/mL of bacteria, exceeding the qualified standard. Conclusion： Medical staff working in operating room in our hospital normally carry bacteria on their nasal vestibules, and there are multiple drug-resistant bacteria. The infection rate of the nursing workers is higher. Early prevention combined with Chinese medicine differentiation should be carried out.