某三甲医院儿科病区患儿耐甲氧西林金黄色葡萄球菌感染现状及危险因素分析  

Current situation and risk factors of methicillin-resistant Staphylococcus aureus infection in children in the pediatric ward of a Grade A hospital

作　　者：杜贵琴[1] 赵滔 田娟 涂瑞 张莹莹[2] 张兵兵 肖祖艳[1] 李雅君[1] DU Guiqin;ZHAO Tao;TIAN Juan;TU Rui;ZHANG Yingying;ZHANG Bingbing;XIAO Zuyan;LI Yajun(Department of Infection Management,the First People's Hospital of Guiyang,Guiyang,Guizhou 550002,China;Department of Paediatrics,the First People's Hospital of Guiyang,Guiyang,Guizhou 550002,China)

机构地区：[1]贵阳市第一人民医院感染管理科,贵州贵阳550002 [2]贵阳市第一人民医院儿科,贵州贵阳550002

出　　处：《医药前沿》2024年第30期10-13,共4页Journal of Frontiers of Medicine

基　　金：贵阳市卫生和计划生育委员会科学技术计划项目([2018]筑卫计科技合同第006号)。

摘　　要：目的:分析贵阳市某三甲医院儿科病区患儿感染耐甲氧西林金黄色葡萄球菌(MRSA)的危险因素.方法:回顾性收集2018年1月—2022年12月贵阳市第一人民医院儿科病区感染金黄色葡萄球菌(SA)患儿的临床资料和病原学资料,并进行菌种鉴定及药敏试验.采用Logistic回归分析患儿感染MRSA的危险因素.结果:共检出SA 581株,其中MRSA 147株,年平均检出率为25.30%.标本来源显示404株来源于痰液,占70.07%.甲氧西林敏感金黄色葡萄球菌(MSSA)组与MRSA组中环丙沙星、苯唑西林、四环素、红霉素、青霉素、利福平的耐药性比较,差异有统计学意义(P<0.05);二分类Logistic回归分析结果显示,早产、使用头孢哌酮-舒巴坦钠、侵入性操作是MRSA感染的危险因素(P<0.05).结论:感染MRSA的患儿主要来源于社区感染,儿科病区开展入院筛查以及针对早产、使用头孢哌酮-舒巴坦钠和接受侵入性操作的患儿开展感染监测,对MRSA院内感染防控具有积极意义.Objective To analyze the risk factors of methicillin-resistant Staphylococcus aureus(MRSA)infection in pediatric patients of a Grade A hospital in Guiyang.Methods Clinical data and etiological data of children infected with Staphylococcus aureus in the pediatric ward of the First People's Hospital of Guiyang from January 2018 to December 2022 were retrospectively collected,and strain identification and drug susceptibility test were conducted.Logistic regression analysis was used to investigate the risk factors of MRSA infection in children.Results A total of 581 strains of Staphylococcus aureus(SA)were detected,including 147 strains of MRSA,with an annual average detection rate of 25.30%.The source of samples showed that 404 strains were derived from sputum,accounting for 70.07%.There were statistically significant differences in drug resistance of cyprofloxacin,oxacillin,tetracycline,erythromycin,penicillin and rifampicin between methicillin-sensitive Staphylococcus aureus(MSSA)group and MRSA group(P<0.05).Binary Logistic regression analysis showed that preterm birth,use of cefoperazone sodium and sulbactam sodium,invasive procedures were independent risk factors for MRSA infection(P<0.05).Conclusions The MRSA children in hospitals mainly come from community infection.Admission screening in pediatric ward and infection monitoring in children with preterm birth,cefoperazone-sulbactam sodium and invasive procedures are of positive significance for the prevention and control of nosocomial infection in MRSA.

关 键 词：儿童 耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 感染 危险因素 

分 类 号：R63[医药卫生—外科学]