医院内耐甲氧西林金黄色葡萄球菌气溶胶的浓度及其粒径分布特征  

Concentration and particle size distribution characteristics of methicillin-resistant Staphylococcus aureus aerosol in hospitals

作　　者：李晓霞[1] 邱玉玉[1] 于爱莲[1] 陈国敏[2] 王占华 张海涛 

机构地区：[1]泰山医学院基础医学院病原生物学研究所,山东泰安271000 [2]泰安市中国人民解放军第88医院检验科,山东泰安271001 [3]泰安市荣军医院检验科,山东泰安271000 [4]泰安市妇幼保健医院新生儿科,山东泰安271000

出　　处：《现代预防医学》2014年第22期4103-4106,共4页Modern Preventive Medicine

基　　金：国家自然科学基金项目(81101307);泰山医学院高等科研计划项目(2012GCC15);泰山医学院博士启动基金(2010);国家大学生科技创新创业训练项目(201310439012)

摘　　要：目的探讨医院中金黄色葡萄球菌及其中耐甲氧西林金黄色葡萄球菌（MRSA）气溶胶的浓度及其粒径分布特征，为医院有效防治气源感染提供基础资料。方法用FA-1型六级筛孔撞击式空气微生物采样器采集3所医院的大厅、ICU及普通外科病房的室内空气。同时采集医院外上风空气作为对照。分析金黄色葡萄球菌及MRSA气溶胶在不同采样点的浓度及其气溶胶粒径分布。结果金黄色葡萄球菌气溶胶总浓度及可吸入浓度均在大厅中最高，分别为166．08cfu／m^3及102．47cfu／m^3，其他依次为病房、ICU及室外；MRSA气溶胶总浓度与可吸入浓度均在ICU中最高，分别为63．60cfu／m^3和28．27cfu／m^3，其次为大厅、普通外科病房及室外。金黄色葡萄球菌及MRSA气溶胶浓度室内外比值均超过1．0。总体上医院内金黄色葡萄球菌可吸入气溶胶颗粒（分布在采样器第三～六级，粒子直径≤4．7μm）占54．80％；医院内MRSA可吸入气溶胶颗粒占54．95％。结论医院空气中存在气载金黄色葡萄球菌及MRSA污染，50％以上的气溶胶粒子≤4．7μm，构成下呼吸道感染威胁，应加强对医院空气中致病菌的监测及消毒工作。Objective This study aimed to evaluate the concentration and particle size distribution characteristics of Staphylococcus aureus and methicillin-resistant S.aureus （MRSA） aerosol in the hospitals, in order to provide fundamental data for preventing related airborne transmission infections. Methods Air samples were collected from indoor air at Main lobby, ICU and surgical wards in three hospitals by FA-1 six-stage microbial samplers. Air samples at one outdoor site upstream of hospital buildings was collected as control. The concentration and distribution characteristics of S.aureus and MRSA aerosol in the hospitals were analyzed. Results The total concentration and the inhalable concentration of S.aureus aerosol were the highest in main lobby, which was 166.08 cfu/m^3 and 102.47 cfu/m^3, respectively, followed in turns by those surgical wards, ICU and outdoors. The total concentration and the inhalable concentration of MRSA areosol were the highest in ICU, which was 63.60 cfu/m^3 and 28.27 cfu/m^3, respectively, followed in turns by those in main lobby, surgical wards and outdoors. The concentration ratio of indoor to outdoor exceeded 1.0 for both S.aureus and MRSA aerosol. Regardless investigation sites, overall the particle size accounted for 54.80% （in grade 3-6, particle diameter ≤4.7 μ m）; the MRSA aerosol particles in hospital accounted for 54.95%. Conclusion The air in the hospitals is contaminated by S.aureus and MRSA aerosol. More than 50% of S.aure us and MRSA aerosol particles were ≤ 4.7 μm, presenting a threat of lower respiratory tract infections. It is necessary to strengthen the monitor and disinfection of airborne pathogens in the hospitals.

关 键 词：耐甲氧西林金黄色葡萄球菌(MRSA) 气溶胶 医院感染 粒径分布 

分 类 号：R122.2[医药卫生—环境卫生学]