神经外科重症监护室MRSA医院感染暴发分析  

Healthcare-associated methicillin-resistant Staphylococcus aureus infection outbreak in neurosurgical intensive care unit

作　　者：范珊红[1] 许文[1] 戈伟[1] 慕彩妮[1] 李颖[1] 曹小琴[1] 许鹏[1] 

机构地区：[1]第四军医大学唐都医院,陕西西安710038

出　　处：《中国感染控制杂志》2015年第4期217-222,共6页Chinese Journal of Infection Control

基　　金：陕西省科技攻关课题(2012K18-01-03)

摘　　要：目的调查某院神经外科重症监护室(NSICU)耐甲氧西林金黄色葡萄球菌(MRSA)医院感染暴发的原因。方法采用前瞻性和回顾性调查相结合的方法,对2014年6月15—28日某院NSICU发生的8例下呼吸道MRSA感染患者进行流行病学调查。结果 2014年6月15—28日该院NSICU患者医院MRSA下呼吸道感染罹患率为22.86%,该期间住院患者临床标本、鼻前庭标本及环境卫生学标本共分离MRSA16株,脉冲场凝胶电泳(PFGE)结果证实此次暴发为2个MRSA亚型感染;危险因素分析显示,住ICU时间长及使用支气管镜吸痰是MRSA下呼吸道感染的危险因素。结论推断NSICU支气管镜污染是此次MRSA医院感染暴发传播的关键因素。Objective To investigate the causes of an outbreak of healthcare-associated infection with methicillin-resist-ant Staphylococcus aureus （MRSA）in a neurosurgical intensive care unit（NSICU）.Methods Epidemiological investigation on 8 patients with lower respiratory tract infection （LRTI）in a NSICU between June 15 and June 28,2104 were performed by combination methods of prospective and retrospective survey.Results The attack rate of MRSA LRTI in NSICU patients was 22.86%,a total of 16 MRSA isolates were detected from patients’clinical specimens,nasal vestibule,as well as hospital surroundings during the period,pulsed-field gel electrophoresis （PFGE）result revealed that infection outbreak was caused by two subtypes of MRSA;risk factors analysis showed that long length of stay in ICU and aspiration of spu-tum through bronchoscopy were risk factors for MRSA LRTI.Conclusion Contamination of bronchoscope was the key factor for this epidemic spread of healthcare-associated MRSA infection.

关 键 词：神经外科 重症监护室 金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 支气管纤维镜 支气管镜 医院感染 暴发 

分 类 号：R378.11[医药卫生—病原生物学]