河北医科大学附属华北石油总医院门诊患者鼻腔MRSA带菌情况调查  

Nasal colonization of methicillin-resistant staphylococcus aureus among patients visiting the North China Oilfield Hospital of Hebei Medical University

作　　者：张卫[1] 孔秋菊[2] 刘华[3] 马延[4] 田艳生[1] 

机构地区：[1]河北医科大学附属华北石油总医院检验科,河北任丘062552 [2]河北医科大学附属华北石油总医院耳鼻咽喉科,河北任丘062552 [3]河北医科大学附属华北石油总医院肾内科,河北任丘062552 [4]河北医科大学附属华北石油总医院药械科,河北任丘062552

出　　处：《中国耳鼻咽喉颅底外科杂志》2013年第1期24-27,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的了解耐甲氧西林金黄色葡萄球菌(methicillin-resistant staphylococcus aureus,MRSA)在华北石油总医院门诊患者鼻腔的带菌状况。方法 2010年5月～2011年7月诊治的502例患者分为MRSA风险组(219例)和无风险组(283例),采集鼻拭子进行细菌培养,并用纸片扩散药敏试验对分离株进行耐药性检测并进行统计学分析。结果①金黄色葡萄球菌、MRSA总的检出率分别为17.3%、3.8%;MRSA风险组检出率均明显高于无风险组,差异均具有统计学意义(P=0.033)。②有留置导管患者金黄色葡萄球菌、MRSA的检出率均明显高于无留置导管患者,差异均具有统计学意义(P=0.001、P=0.002)。③MRSA无风险组的MRSA分离株对氯洁霉素、多西环素、红霉素的敏感性均高于MRSA风险组,差异均具有统计学意义(P=0.041、P=0.05、P=0.041)。结论有MRSA定植风险因素的门诊患者鼻腔MRSA带菌率较高,留置导管是MRSA定植的危险因素。Objective To understand the carriage rate of methiciUin-resistant staphylococcus aureus （MRSA） among the patients visiting the North China Oilfield Hospital. Methods From May 2010 to July 2011, a total of 502 patients visiting the North China Oilfield Hospital were recruited and surveyed for nasal carriage of MRSA. 219 patients （44%） were classified into the group with risk factors for MRSA acquisition and 283 （56%） patients into the group without risk factors. Nasal swab samples were collected with sterile swabs in all patients and sent to microbiological laboratory for culture. The susceptibility was tested using the disk-diffusion method. Results ① The overall prevalence rates of S. aureus and MRSA were 17.3 % and 3.8 % respectively. The carriage rates of S. aureus and MRSA in the patients with risk factors were significantly higher than those without risk factors respectively （ P 〈 0.05 ）. ② The colonization rates of S. aureus and MRSA in patients with catheters/tubes retention were significantly higher than those without （ P = 0. 001, P = 0. 002, respectively ）. ③ The susceptibilities to clindamycin, doxycyclin, and erythromycin of MRSA isolates from patients without risk factors were significantly higher than those from the patients with risk factors （ P = 0.041, P = 0.05, P = 0.041, respectively）. Conclusion The nasal carriage rate of MRSA in patients with risk factors for acquisition is significantly higher than that in those without risk factors. Catheters or tubes retention is a risk factor for MRSA colonization.

关 键 词：耐甲氧西林金黄色葡萄球菌 鼻腔 微生物敏感性试验 

分 类 号：R378[医药卫生—病原生物学] R978[医药卫生—基础医学]