医院MRSA感染危险因素研究  

Risk factors for nosocomial methicillin-resistant Staphylococcus aureus infections

作　　者：舒明[1] 

机构地区：[1]上海市普陀区疾病预防控制中心,上海200333

出　　处：《中国感染控制杂志》2010年第3期160-163,共4页Chinese Journal of Infection Control

基　　金：上海市卫生局科研课题资助(2007184)

摘　　要：目的探讨医院耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)感染的危险因素,为采取有效措施降低医院MRSA感染率提供科学的依据。方法用1:1成组病例对照研究,根据样本量需求,纳入合格研究对象108对。采用统一设计的调查表,通过查阅病例组和对照组的病史资料收集信息。资料分析采用x^2检验和非条件Logistic回归模型等统计方法。结果分析显示,与医院MRSA感染有关的因素为:高龄(≥65岁,P=0.013)、住院时间(P<0.001)、基础疾病种类(P<0.001)、侵入性操作项数(P<0.001)、广谱抗菌药物的使用(P<0.001)、抗菌药物种类(P=0.004)和使用时间(P<0.001);多因素分析显示,与医院MRSA感染有关的主要危险因素包括:住院时间(P<0.001)、侵入性操作项数(P=0.001)、抗菌药物使用种类(P=0.001)和使用时间(P<0.001)等。结论住院时间长、侵入性操作项数多、长期使用广谱抗菌药物及使用抗菌药物种类多是医院MRSA感染的危险因素。Objective To explore the risk factors for nosocomial methicillin-resistant Staphylococcus aureus （MR- SA） infection, so as to provide a scientific basis for taking effective measures to reduce nosocomial MRSA infection rates. Methods 1 ： 1 case-control study was performed, 108 pairs of research subjects were included in the research. Questionnaires were designed to study the history of case and control data. Multivariate non-conditional Logistic regression and ehi square test were used to analyze the data. Results Analysis showed that the following factors were associated with nosocomial MRSA infection： old age （≥65 years old, P = 0. 013）, length of stay in hospital （P〈 0. 001）, the types of underlying disease （P〈0. 001）, the number of invasive procedures （P〈0. 001）, broad-spectrum antimicrobial use（P〈0. 001）, types of antimicrobial agents （P = 0. （104） and duration use of antimicrobial agents （P〈0. 001）. Multivariate analysis showed that the main risk factors related to nosocomial MRSA infection included length of stay in hospital （P〈0. 001）, the number of invasive procedures （P= 0. 001）, types of used antimicrobial （P = 0. 001） and duration use of antimicrobials （P〈0. 001）. Conclusion Risk factors for nosocomial MRSA infections are long length of stay in hospital , frequent invasive operations , and long-term as well as multiple use of broad-spectrum antimicrobial agents.

关 键 词：耐甲氧西林金黄色葡萄球菌 医院感染 危险因素 病例对照研究 病原学 抗药性 微生物 

分 类 号：R378.11[医药卫生—病原生物学]