2008-2010年MRSA目标监测与干预效果  

Targeted monitoring of methicillin-resistant Staphylococcus aureus and effect of intervention measures during 2008-2010

作　　者：林璇[1] 郭燕艺[1] 甘明秀[1] 张艳青[1] 陈玉芳[1] 

机构地区：[1]福建省立医院院感科,福建福州350001

出　　处：《中华医院感染学杂志》2011年第20期4217-4219,共3页Chinese Journal of Nosocomiology

摘　　要：目的通过对耐甲氧西林金黄色葡萄球菌(MRSA)目标监测及干预措施的落实,以期降低MRSA医院感染率,提高医疗质量。方法每日从医院实验室信息管理系统(LIS)查阅MRSA检出情况,结合临床判定医院感染及社区感染,督促并指导临床落实干预措施。结果 2008-2010年MRSA的检出率由2008年52.88%下降至2009、2010年的39.71%、44.62%;MRSA千床日医院感染率由2008年的0.13‰下降至2010年的0.03‰,差异有统计学意义(χ2=50.683,P<0.01);MRSA对庆大霉素、阿米卡星、磺胺甲噁唑/甲氧苄啶、青霉素G、红霉素、克林霉素、氯霉素、四环素、左氧氟沙星的耐药率均呈不同程度下降,其中阿米卡星、磺胺甲噁唑/甲氧苄啶、左氧氟沙星耐药率下降明显,分别由2008年的67.06%、41.75%、64.71%下降至2010年的32.14%、13.10%、50.00%,未出现对万古霉素、替考拉宁、利奈唑胺耐药菌株。结论通过综合干预措施的实施可有效降低MRSA医院感染的发生,提高医疗质量。OBJECTIVE To decrease the Methicillin-resistant Staphylococcus aureus（MRSA） infection rate and improve the medical quality through targeted monitoring of MRSA and implementation of intervention measures.METHODS According to the detection of MRSA from the system LIS of our hospital,combined with clinical to judged the infection,the hospital infection or community acquired infection were supervised and directed clinical interventions put into practice.RESULTS The relevance ratio of MRSA was decreased from the 52.88% of 2008 to the 39.71% of 2009 and to the 44.62% of 2010.Much lower than the rate of nationwide 67.06%,32.14%,13.10% and 50.00%,separately.Hospital acquired infection rate of MRSA based on thousand beds daily was statistical lower from 0.13‰ of 2008 to 0.03‰ of 2010（χ2=50.683,P〈0.001）.And the drug resistance rate of MRSA to gentamicin,amikacin,compound sulfamethoxazole,penicilline G,erythromycin,clindamycin,chloramphenicol,tetracycline and levofloxacin were lower with differently level.Among them amikacin,compound sulfamethoxazole and levofloxacin had much lower rates,from the 67.1%,41.7%,64.7% of 2008 to 32.1%,13.1%,50.0% of 2010.No drug resistance bacterial strains to vancomycin,teicoplanin and linezolid was found.CONCLUSION The implementation of comprehensive intervening measures can reduce the hospital infection rate of MRSA and improve the health care quality.

关 键 词：耐甲氧西林金黄色葡萄球菌 目标监测 干预效果 

分 类 号：R181.32[医药卫生—流行病学]