新生儿重症监护病房耐甲氧西林金黄色葡萄球菌定植率和危险因素分析

Analysis on Colonization Rate and Risk Factors of Methicillin-resistant Staphylococcus Aureus in Neonatal Intensive Care Unit

目的:分析新生儿重症监护病房耐甲氧西林金黄色葡萄球菌皮肤定植率和危险因素。方法:抽取2017年2月—2018年2月间在医院重症监护病房治疗的新生儿200例资料作为研究对象,统计资料中采集的新生儿鼻翼两侧和鼻腔底部用无菌棉拭子标本,并进行金黄色葡萄球菌培养和鉴定的结果;通过PCR法检测mec A基因鉴定耐甲氧西林金黄色葡萄球菌,分析定植率以及相关因素。结果:金黄色葡萄菌的皮肤定植率为22%高于耐甲氧西林金黄色葡萄球菌皮肤定植率为5%(P<0.05);新生儿耐甲氧西林金黄色葡萄球菌皮肤定植率在住院的第1天、第3天、第7天呈上升趋势;而耐甲氧西林金黄色葡萄球菌和侵入性操作、抗生素使用呈正相关。结论:重症监护病房的新生儿具有较高的耐甲氧西林金黄色葡萄球菌皮肤定植率,且定植率在住院的第7天内随着住院时间延长而增长,与侵入性操作、抗生素使用等因素具有密切关系。

Objective： To analyze the skin colonization rate and risk factors of methicillin-resistant Staphylococcus aureus in neonatal intensive care unit（NICU）. Methods： From February 2017 to February 2018, 200 newborns treated in ICU were selected as the subjects. The specimens were collected from both sides of the nasal alar and the bottom of the nasal cavity with aseptic cotton swabs, and the culture and identification of Staphylococcus aureus were carried out.The mec A gene was detected by PCR to identify methicillin-resistant Staphylococcus aureus, and the colonization rate and related factors were analyzed. Results： The skin colonization rate of Staphylococcus aureus was 22.00%, the skin colonization rate of methicillin resistant Staphylococcus aureus was 5.00% and the difference between the groups was statistically significant（P〈0.05）. The skin colonization rate of methicillin resistant Staphylococcus aureus was increased in day 1, day 3 and day 7 in the hospital, and methicillin resistant Staphylococcus aureus was positively correlated with invasive operation and antibiotic use. Conclusion： The NICU has a higher rate of skin colonization of methicillin resistant Staphylococcus aureus, and the rate of colonization increases with the duration of hospitalization in day 7,which is closely related to invasive operation, antibiotic use and so on.