医务人员手耐甲氧西林葡萄球菌携带调查及药敏分析  

Analysis on carrying rate and antimicrobial susceptibility of methicillin-resistant Staphylococcus on medical staff's hands

作　　者：李瑜珍[1] 谢懿[1] 何绪屏[1] 

机构地区：[1]深圳市中医院,广东深圳518033

出　　处：《中国感染控制杂志》2008年第6期416-418,434,共4页Chinese Journal of Infection Control

基　　金：深圳市科技计划项目(200703189)

摘　　要：目的调查医务人员手耐甲氧西林葡萄球菌(MRS)的携带及药敏情况。方法随机抽取某院168名医务人员,分别采集其按六步洗手法洗手前后的手部皮肤拭子标本(共336份)进行MRS分离培养和药敏试验。结果医务人员手MRS携带率在洗手前高达66.67%,而洗手后仍有41.07%,但两者比较,差异有显著性(χ2=22.14,P<0.01)。所携带的MRS均为耐甲氧西林凝固酶阴性葡萄球菌(MRCNS),未检出耐甲氧西林金黄色葡萄球菌(MRSA)。检出的MRCNS除对万古霉素敏感、对呋喃妥因耐药率较低外,对β-内酰胺类抗生素的青霉素、氨苄西林、阿莫西林/克拉维酸、头孢噻吩、头孢噻肟表现出高度耐药,耐药率为70.37%～100.00%;对环丙沙星、红霉素、四环素、克林霉素、复方磺胺甲口恶唑的耐药率达42.33%～80.42%;其耐药率显著高于对甲氧西林敏感的葡萄球菌,并表现出多重耐药。结论医务人员手MRS的高携带率应引起广大医务工作者的高度重视。采用六步洗手法洗手有助于减少MRS携带,减少医源性MRS的蔓延和流行。Objective To investigate the carrying condition and antimicrobial susceptibility of methicillin-resistant Staphylococcus （MRS） on medical staffs hands. Methods One hundred and sixty-eight medical staffs were selected randomly in a hospital, 336 swabs samples were collected from their hand skin before and after ＂six-step＂ hand washing respectively. The samples were prepared for isolated culture of MRS as well as antimierobial susceptibility tests. Results The carrying rate of MRS on medical staffs＇ hands was 66. 67% and 41.07% before and after hand washing respectively, there was significant difference between the two （X^2 = 22. 14, P〈0. 01）. All of MRS were methicillin-resistant Coagulase negative staphylococcus （MRCNS）, methieillin-resistant Staphylococcus aureus （MRSA） wasn＇t found. Except the relatively lower drug-resistant rates to vancomycin and nitrofurantoin, drug-resistance rates were all high to penicillin, ampicillin, amoxicillin/elavulanic acid,cefalotin and cefotaxime（70. 37%- 100. 00%） ; the resistant rate to ciprofloxacin, erythromycin, clindamyein, trimethoprim-sulfamethoxazole was 42. 33-80. 42%; The drug resistance rate of MRS was obviously higher than that of methicillin-sensitive Staphylococcus, and the multiply drug resistance was observed. Conclusion High carrying rates of MRS on medical staff＇s hands should be paid more attention. Six-step hand washing can reduce the carrying rates of MRS as well as the spread and prevalence of MRS among hospital.

关 键 词：医务人员 洗手 耐甲氧西林葡萄球菌 医院感染 抗药性 微生物 

分 类 号：R181.32[医药卫生—流行病学]