MRSA医院感染的特点及预防措施的研究  

Investigation on Characteristics and Preservation Measure of Methicillin-Resistant Staphylococcus Aureus Nosocomial Infection

作　　者：周宏[1] 康海全[1] 任玲[1] 韩方正[1] 茅一平[1] 

机构地区：[1]江苏省徐州医学院附属医院感染管理科,221002

出　　处：《中华全科医学》2009年第10期1043-1044,共2页Chinese Journal of General Practice

摘　　要：目的探讨MRSA医院感染的分布特点及耐药性变化,为预防控制措施的制定提供依据。方法采用前瞻性调查的方法进行医院感染病例监测,发现医院感染病例及时留取相关标本进行病原微生物培养和药物敏感试验;对SA医院感染154例进行分析。结果MRSA医院感染112例,其高发科室为神经外科、ICU、神经内科,主要感染部位为下呼吸道、手术切口和血液感染。MRSA除对万古霉素敏感外,对其他抗菌药物都存在不同程度的耐药,耐药率较低的是呋喃妥因(6.33%)、米诺环素(35.71%),其次是阿米卡星(62.03%)、利福霉素(68.37%),而对β-内酰胺类、克林霉素、红霉素、氟喹诺酮类的耐药率高达90%～100%。MRSA对抗菌药物的耐药率明显高于MSSA(P<0.01)。结论MRSA存在严重的耐药和多重耐药性;加强耐药菌的监测,了解MRSA的分布特点,对于及早发现MRSA医院感染,以便早期采取隔离、治疗措施,防止MRSA的暴发流行有着极其重要的意义。Objective To study the distributing and drug-resistance of methicillin-resistant staphylococcus anreus （MRSA） nosocomial infection（ NI）, and provide a basis for preservation measures of MRSA NI. Methods Using the prospective monitoring methods to monitor NI. Samples were took timely from patients of NI to culture for pathogenic micro-organisms and to test drug sensitivity. 154 of SA NI were analyzed. Results 112 MRSA NI was 69.14% in the total 154 NI of Staphylococcus aureus ＇（SA）. The department which was high incidence of MRSA NI included neurosurgery and ICU and neurology department. The main infection sites of MRSA NI were lower respiratory tract and operative incision and blood. In addition to vancomycin, other antibiotics was varying degrees of resistance for MRSA, for example Nitrofurantoin （ 6.33% ）, minocycline （ 35.71% ）, followed by amikacin （62.03 % ）, rifamycin （ 68.37 % ）, while β-1actams, clindamycin, erythromycin, fluoroquinolone resistance rates was as high as 90% to 100%. The drug-resistance rate of MRSA was significantly higher than that of MSSA（P 〈 0.01 ）. Conclusion MRSA shows serious drug-resistance and multiple drugresistance. It is important to detect MRSA NI early, and to isolate and treat the patients with MRSA or prevent the outbreak of MRSA NI from strengthening the monitoring and understanding the distribution of MRSA NI.

关 键 词：MRSA 医院感染 分布特点 耐药性 预防 

分 类 号：R378.11[医药卫生—病原生物学] R63[医药卫生—基础医学]