某医院重症监护病房与普通病房耐甲氧西林金黄色葡萄球菌医院感染特征及耐药性分析  

Analysis of clinical characteristics and drug resistance of methicillin resistant Staphylococcus aureus nosocomial infections between intensive care unit and general ward in a hospital

作　　者：李慧[1] 孙湘 宋晓超 韦杰 LI Hui;SUN Xiang;SONG Xiao-chao;WEI Jie(The First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215006

出　　处：《中国消毒学杂志》2025年第3期197-199,202,共4页Chinese Journal of Disinfection

基　　金：苏州市医院协会感染管理专项重点项目(SZSYYXH-2023-ZD1)。

摘　　要：目的 调查普通病房和重症监护病房(ICU)耐甲氧西林金黄色葡萄球菌(MRSA)医院感染的分布和耐药性。方法 采用回顾性调查方法,收集2016—2020年304 261例住院患者的病历和实验室检测资料;比较ICU和普通病房患者MRSA感染率、检出率和耐药差异。结果 共发生MRSA医院感染263例次,例次感染率为0.09%;ICU例次感染率高于普通病区(0.85%vs 0.04%;χ^(2)=1 413.805,P<0.001)。MRSA医院感染均以下呼吸道感染为主,ICU以呼吸机相关性肺炎感染率较高。送检标本MRSA分离株均对万古霉素、替考拉宁和替加环素敏感;ICU标本MRSA分离株对环丙沙星、莫西沙星和四环素耐药率高于普通病房分离株(P<0.05)。结论 ICU和普通病房MRSA医院感染多发生于下呼吸道,应采取针对性措施,重点加强ICU医院感染防控,并结合药敏试验结果合理用药。Objective To investigate the epidemic distribution and drug resistance characteristics of methicillin resistant Staphylococcus aureus nosocomial infection in general ward and ICU.Methods Using a retrospective survey method,medical records and laboratory testing data were collected for 304261 hospitalized patients from 2016 to 2020.The differences in MRSA infection rate,detection rate,and drug resistance between ICU and general ward patients were compared.Results A total of 263 cases of MRSA nosocomial infection occurred,with an infection rate of 0.09%.The case infection rate in ICU cases was higher than that in general wards(0.85%vs 0.04%;χ^(2)=1413.805,P<0.001).MRSA nosocomial infections were mainly caused by lower respiratory tract infections,with a higher incidence rate of ventilator-associated pneumonia infections in the ICU.The MRSA isolates were sensitive to vancomycin,teicoplanin and tigecycline.The resistance rate of MRSA isolates from ICU specimens to ciprofloxacin,moxifloxacin,and tetracycline was higher than that of general ward isolates(P<0.05).Conclusion ICU and general ward MRSA nosocomial infections often occur in the lower respiratory tract,and targeted measures should be taken to strengthen ICU nosocomial infection prevention and control.Drugs should be used reasonably based on drug sensitivity test results.

关 键 词：重症监护病房 普通病房 医院感染 耐甲氧西林金黄色葡萄球菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]