2010-2014年医院金黄色葡萄球菌感染的流行病学研究与耐消毒剂分析  

Epidemiologic study of Staphylococcus aureus infection and analysis of resistance to disinfectants

作　　者：糜琛蓉[1] 倪语星[1] 唐毅[2] 王丹霓[1] 沙天宇 宿飞[2] 何景雄[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院院感科,上海200025 [2]上海市黄浦区疾病预防控制中心消毒与感染控制科,上海200023

出　　处：《中华医院感染学杂志》2016年第11期2444-2446,2570,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81472010);上海卢湾区卫生局科研基金资助项目(卢卫科1051)

摘　　要：目的了解2010-2014年医院金黄色葡萄球菌感染的现状,为临床干预与研究奠定基础。方法选择医院2010-2014年1 730例金黄色葡萄球菌感染的住院患者临床资料进行研究,将其分为MRSA组和MSSA组,从性别、年龄、科室、检出部位、逐年检出状况、耐药基因等方面,采用SPSS 19.0软件进行统计分析。结果 1 730例金黄色葡萄球菌感染患者中,男性MRSA检出率为62.25%、女性为54.95%,差异有统计学意义（P〈0.05）;21-30岁组患者MRSA检出率最低为53.42%,71-80岁组患者检出率最高为73.76%,差异有统计学意义（P〈0.05）;2010-2014年每年送检的标本量有逐年下降趋势,不同年份MRSA检出率比较,差异有统计学意义（P〈0.05）;MRSA检出率排前3位的科室分别为ICU、普外科和神经内科,分别为80.26%、72.65%和70.69%;MRSA检出率前3位的标本来源为深静脉导管、痰液和烧伤创面,分别为79.45%、69.80%、64.54%;经Yates连续校正χ^2检验,MSSA与MRSA携带qac（A）基因阳性率差异有统计学意义（χ^2=5.80,P〈0.05）。结论 MRSA是常见的耐药菌,SAU携带qac（A）基因对抗菌药物和消毒剂的抗力会增强,MRSA更容易产生耐药和耐消毒剂,要加强监控,提高消毒效果,减少MRSA产生。OBJECTIVE To investigate the prevalence of Staphylococcus aureus infection in 2010-2014 so as to lay foundation for clinical intervention and study.METHODS The clinical data of 1 730 patients with S.aureus infection who were hospitalized from 2010 to 2014were studied,the enrolled patients were divided into the MRSA group and the MSSA group.The gender,age,departments,detected sites,isolation rates,and drug resistance genes were observed,and the statistical analysis was performed with the use of SPSS 19.0software.RESULTS Among the 1 730 patients,the isolation rate of MRSA was 62.25%in the male patients,54.95%in the female patients,and there was significant difference（P〈0.05）.The isolation rate of MRSA was lowest（53.42%）in the patients aged from 21 to 30years old and was highest（73.76%）in the patients aged from 71 to 80years old,and there was significant difference（P〈0.05）.The annual amount of the submitted specimens showed downward trend from 2010 to 2014,and there was significant difference in the isolation rates of MRSA among the different years（P〈0.05）.The isolation rate of MRSA was 80.26%in the ICU,72.65%in the department of general surgery,70.69%in the department of neurology.Among the 1 961 submitted specimens,the isolation rate of MRSA was79.45%in the deep venous catheter,69.80%in the sputum specimens,64.54%in the burn wound specimens.The Yates continuous correction chi square test showed that there was significant difference in the positive rate of qac（A）gene between the MSSA and the MRSA（χ2=5.80,P 0.05）.CONCLUSION The MRSA is a common species of drug-resistant bacteria,the S.aureus strains carrying with the qac（A）gene are highly resistant to antibiotics and disinfectants,and the MRSA strains tend to be drug-resistant or disinfectant-resistant.It is necessary to strengthen the monitoring and improve the disinfection effect so as to reduce the MRSA strains.

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 流行病学 耐消毒剂 

分 类 号：R378.11[医药卫生—病原生物学]