耐甲氧西林金黄色葡萄球菌医院感染危险因素分析  

Risk factors of methicillin-resistant Staphylococcus aureus infection

作　　者：陈亮[1] 符力[1] 李苑[2] 旋妮玲[1] 蔡明伟[3] 王烨 

机构地区：[1]广东省医学科学院广东省人民医院,广东广州510080 [2]深圳市宝安区疾病预防控制中心,广东深圳518101 [3]广州市荔湾区疾病预防控制中心,广东广州510176 [4]广州市荔湾区人民医院,广东广州510370

出　　处：《中国热带医学》2012年第10期1243-1246,共4页China Tropical Medicine

摘　　要：目的了解MRSA医院感染的情况,分析引起感染的危险因素及细菌的抗生素耐药谱。方法于2012年1月～2012年5月在本院收集分离出的不重复金黄色葡萄球菌,对分离出来的金黄色葡萄球菌进行抗生素药敏试验。采用自行设计调查表,收集患者在金黄色葡萄球菌检出前病案资料,分析其危险因素。结果分离的83株金黄色葡萄球菌,33株(39.8%)为MRSA,红霉素、克林霉素、庆大霉素、环丙沙星及复方新诺明在MRSA菌株的耐药情况更为严重(P值分别为0.009,0.006,0.018,0.021,0.022)。多元logistic回归分析显示,住院时间超过10d、至少使用3种抗生素、深静脉插管、一年前曾经住院、住院时有皮肤软组织感染、住院时发生菌血症、住院时有呼吸衰竭为MRSA感染的危险因素(OR值分别为5.397,6.416,5.576,6.926,14.805,16.462,12.566)。结论金黄色葡萄球菌多药耐药情况严重,MRSA感染因素多,原因复杂,应主动监测金黄色葡萄球菌感染情况。Objective Methicillin-resistant Staphylococcus aureus （MRSA） is a serious public health problem worldwide. We sought to determine the infection of Methicillin-resistant Staphylococcus aureus among patients in the hospital, a total of 83 S.aureus isolates were collected, potential risk factors associated with S.aureus infection and antimicrobial susceptibility were determined. Methods A prospective observational study was conducted from January 2012 to May 2012 in a single tertiary hospital. The non-duplicated isolates were characterized by antibiogram analysis. A self made questionnaire was administered, and potential risk factors independently associated with MRSA were determined. Results Of 83 S.aureus isolates,33 （39.8%）ereMRSA,theresistantto erythromycin,clindamycin,gentamiein,ciprofloxaein,trimethoprim-sulfamethoxazole among MRSA strains were significantly different from that among MSSA strains （P=0.009,0.006,0.018,0.021,0.022, respectively ）. Hospitalization 〉 10d, at least 3 antibiotic were simultaneously used, deep venous catheter used, previous hospitalization, SSTI, bacteremia and respiratory failure were the independent risk factors of MRSA infection in hospitalization patients （OR, 5.397, 6.416,5.576,6.926, 14.805,16.462,12.566 , respectively） in multivariate analysis. Conclusions The multidrug resistance was severe in serious cases of MRSA. The MRSA infection was affected by many factors, the situation was complicated. It is necessary for active surveillance of S. aureus infection in hospitals.

关 键 词：耐甲氧西林金黄色葡萄球菌 感染 危险因素 

分 类 号：R378.11[医药卫生—病原生物学]