口腔医院多重耐药菌感染住院患者病房环境污染调查  

Contamination of ward environment of patients with multidrug-resistant organism infection in a stomatology hospital

作　　者：刘翠梅[1] 辛鹏举[2] 何淳[2] 林海燕[2] 詹思延[1] 

机构地区：[1]北京大学公共卫生学院,北京100191 [2]北京大学口腔医院,北京100081

出　　处：《中国感染控制杂志》2015年第12期824-826,共3页Chinese Journal of Infection Control

摘　　要：目的了解病区环境中多重耐药菌(MDRO)检出情况,为临床预防和控制MDRO传播提供依据。方法某口腔专科医院2012年9月—2014年7月收治MDRO感染患者作为实验组,随机抽取的12例未感染MDRO患者作为对照组,对其周围环境物品表面进行微生物采样和培养,对微生物进行鉴定和药敏试验。结果 44例MDRO感染者中,13例患者周围环境中检出相应的MDRO,总体MDRO检出率为29.55%(13/44)。耐甲氧西林金黄色葡萄球菌(MRSA)在环境各物体表面均有检出,检出率为45.45%(5/11),多重耐药鲍曼不动杆菌(MDRAB)检出率为66.67%(2/3),耐甲氧西林表皮葡萄球菌(MRSE)检出率为66.67%(6/9)。MRSA感染患者鼻腔、手MRSA检出率分别为72.73%、54.54%,其陪护人员鼻腔、手MRSA检出率分别为36.36%、18.18%。实验组和对照组周围环境物品细菌菌落数比较,差异无统计学意义(均P>0.05)。结论口腔医院MDRO感染者周围环境物品表面MDRO检出率高于非MDRO感染者,应加强MDRO感染者周围环境的监控、清洁和消毒,预防MDRO医院传播。Objective To realize the isolation of multidrug-resistant organisms（MDROs）from ward environment,and provide evidence for clinical prevention and control of MDRO transmission.Methods Patients with MDRO infection in a stomatology hospital from September 2012 to July 2014 were as trial group,12 randomly selected patients without MDRO infection were as control group,environmental object surface in patients＇ ward were taken specimens and performed culture,isolated organisms were identified and performed antimicrobial susceptibility testing.Results Of 44 patients with MDRO infection,13 patients＇ surrounding environment were detected MDROs,the total detection rate was 29.55%（13/44）.The detection rate of methicillin-resistant Staphylococcus aureus（MRSA）,multidrugresistant Acinetobacter baumannii（MDRAB）,and methicillin-resistant Staphylococcus epidermidis（MRSE）were 45.45%（5/11）,66.67%（2/3）and 66.67%（6/9）respectively.Detection rates of MRSA from nasal cavity and hands of MRSAinfected patients were 72.73%and54.54%respectively,from nasal cavity and hands of patients＇ caregivers were 36.36%and 18.18%respectively.The difference in bacterial count between trial group and control group was not significantly different（all P0.05）.Conclusion Isolation rate of MDROs from ward environment of MDRO-infected patients is higher than that of non-MDRO-infected patients,monitoring,cleaning and disinfection for MDRO-infected patients＇ surrounding environment should be strengthened,so as to prevent the spread of MDROs in hospital.

关 键 词：多重耐药菌 监测 环境 口腔医院 

分 类 号：R181.32[医药卫生—流行病学]