新生儿MRSA筛查定植率与MRSA院感的相关性研究

Study on correlation between MRSA screening colonization rate in neonates and MRSA nosocomial infection

目的分析新生儿耐甲氧西林金黄色葡萄球菌(MRSA)定植率与MRSA医院内感染(院感)的相关性,为临床制订预防和降低MRSA院感相关干预措施提供理论依据。方法对2014年1月至2018年12月入住该院新生儿科的10864例患儿咽拭子MRSA定植筛查结果及发生MRSA院感情况进行回顾性分析。将2014—2015年该院新生儿科旧病区收集数据作为对照组,2016—2018年搬迁至层流病房的数据作为观察组。结果10864例新生儿检出MRSA定植菌株482株(4.44%),其中对照组检出406株(84.23%),观察组检出76株(15.77%)。2组新生儿MRSA定植菌株检出率比较,差异有统计学意义(P<0.05);10864例新生儿发生MRSA院感9例,其中对照组3例(0.07%),观察组6例(0.09%)。2组新生儿MRSA院感发生率比较,差异无统计学意义(P>0.05)。结论新生儿住院病房的改造升级及配套硬、软件的改进可有效降低MRSA定植率;以标准预防为基础的综合干预措施能很好地控制新生儿MRSA由定植向院感的转化。

Objective To analyze the correlation between MRSA colonization situation and the occurrence of MRSA nosocomial infection among neonates at the same period in order to provide a theoretical basis for formulating the corresponding interventional measures to prevent and reduce MRSA nosocomial infection.Methods The MRSA colonization screening results in the throat swabs from 10864 neonatal patients in the neonatal department of this hospital from January 2014 to December 2018 and MRSA nosocomial infection situation in this department were retrospectively analyzed.The data collected from the old wards of the neonatal department of this hospital during 2014-2015 served as the control group and the data collected from the laminar air flow wards relocated during 2016-2018 served as the observation group.Results Among 10864 neonates,482 strains(4.44%)of MRSA were detected,in which 406 strains(84.23%)were in the control group and 76 strains(15.77%)were in the observation group.The detection rate of MRSA colonization strains had statistical difference between the two groups(P<0.05).Among 10864 neonates,there were 9 cases of MRSA infection,3 cases(0.07%)were in the control group and 6 cases(0.09%)in the observation group.The MRSA nasocomial infection had no statistically significant difference between the two groups(P>0.05).Conclusion The reconstruction and upgrading of the neonatal inpatient ward and the improvement of matched hardware and software can effectively reduce the colonization rate of MRSA.The comprehensive intervention measures based on the standard prevention can well control the transformation of neonatal MRSA from colonization to nosocomial infection.