儿童呼吸科婴儿耐甲氧西林金黄色葡萄球菌鼻定植的危险因素  

Risk factors of methicillin-resistant staphylococcus aureus nasal colonization among infants in pediatric respiratory department

作　　者：张双红 贾晓慧[2] 吴玉洁 吕俊英[3] 张丽萍[4] ZHANG Shuanghong;JIA Xiaohui;WU Yujie;LYU Junying;ZHANG Liping(The Second Clinical College, Wenzhou Medical University, Wenzhou 325035, China;Department of Pediatric Respiration, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou MedicalUniversity, Wenzhou 325027, China;Department of Neonatal Intensive Care Unit, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China;Department of Clinical Skill Training, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China)

机构地区：[1]温州医科大学第二临床医学院,浙江温州325035 [2]温州医科大学附属第二医院育英儿童医院儿童呼吸科,浙江温州325027 [3]温州医科大学附属第二医院育英儿童医院新生儿科,浙江温州325027 [4]温州医科大学附属第二医院育英儿童医院临床技能中心,浙江温州325027

出　　处：《温州医科大学学报》2019年第2期91-95,共5页Journal of Wenzhou Medical University

基　　金：卫生部国家临床重点专科(儿童呼吸)基金资助项目(20130110)

摘　　要：目的:探讨儿童呼吸科婴儿耐甲氧西林金黄色葡萄球菌(MRSA)鼻定植的危险因素,为临床干预提供参考依据。方法:本研究为横断面研究,纳入2017年4月至2018年3月期间入住温州医科大学附属第二医院育英儿童医院儿童呼吸科的患儿,收集病例资料,在鼻前庭采集鼻拭子标本进行细菌培养,观察MRSA鼻定植情况,分析婴儿MRSA鼻定植的危险因素。结果:成功采集鼻拭子标本的婴儿共759例,符合纳入标准的病例492例,检出MRSA 46例,MRSA鼻定植率为6.1%。单因素分析结果示:MRSA鼻定植与月龄、分娩方式、住院天数、家庭主要成员1年内有无住院史、家庭主要成员中有无医务工作者有关(P<0.05)。多因素logistic回归分析显示,月龄>6个月婴儿MRSA鼻定植率明显低于月龄≤6月者(OR=0.164,95%CI:0.049～0.545),而家庭主要成员中有医务人员(OR=9.428,95%CI:2.635～33.731)、住院天数(OR=1.099,95%CI:1.008～1.197)是MRSA鼻定植的独立危险因素。结论:月龄≤6月的婴儿有较高的MRSA定植率,家庭主要成员中有医务工作者的婴儿为MRSA鼻定植的高危人群,MRSA鼻定植会增加患儿的住院天数。Objective: To investigate risk factors of methicillin-resistant staphylococcus aureus (MRSA) nasal colonization in pediatric respiratory department,and to provide reference for clinical intervention. Methods: The cross-sectional study started from April 2017 to March 2018 in pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University. Newly admitted patients were screened daily for their eligibility. For enrolled patients,specimens from nasal vestibule were taken and cultured. The nasal colonization of MRSA and its risk factors were analyzed. Results: A total of 759 infantswere successfully collected specimens. Finally,492 infants met the entrollment criteria and 46 were found with colonization MRSA (6.1%). Univariate analysis results indicated that MRSA nasal colonization was associated with months of age,delivery mode,history of hospitalization of the family members over the past year and whether any of family members is healthcare provider (P<0.05). Multi-variant logistic regression analysis indicated that over six months of age (OR=0.164,95%CI: 0.049-0.545) was protective factor,and one of the family members is healthcare provider (OR=9.428,95%CI: 2.635-33.731),length of hospitalization stay (OR=1.099,95%CI: 1.008-1.197) were independent risk factors of MRSA nasal colonization. Conclusion: There is a high morbidity of MRSA nasal colonization in patients less than six month of age. The risk factor of colonization is healthcare provider in the family. MRSA nasalcolonization will increase the length of hospitalization stay.

关 键 词：婴儿 耐甲氧西林金黄色葡萄球菌 定植 危险因素 儿童呼吸科 

分 类 号：R174[医药卫生—妇幼卫生保健]