儿童耐甲氧西林金黄色葡萄球菌医院感染现状与感染因素分析

目的 分析医院住院儿童耐甲氧西林金黄色葡萄球菌(MRSA)医院感染现状与因素,为预防、控制住院儿童MRSA医院感染提供参考.方法 回顾性分析医院2008年1月-2010年12月儿科259例住院患儿临床资料,采用单因素分析法从年龄、性别、抗菌药物使用、住院时间等方面进行感染率的比较分析.结果 259例患儿的各种临床标本中共分离出金黄色葡萄球菌259株,其中MRSA 94株,检出率为36.3％；94例儿童中男童46例占48.9％,女童48例占51.1％,男女组间比较差异无统计学意义；年龄分布为＜3岁34例、3～7岁46例、7～11岁14例,分别占36.2％、48.9％、14.9％,差异有统计学意义(P＜0.05)；抗菌药物使用＜2周者占29.8％、≥2周者占70.2％,差异有统计学意义(P＜0.05)；住院时间＜2周者占33.3％,≥2周者占67.0％,差异有统计学意义(P＜0.05).结论 住院儿童耐甲氧西林金黄色葡萄球菌医院感染与年龄、抗菌药物使用时间、住院时间等密切相关；积极进行病原学监测,及时发现和隔离MRSA感染病例,合理使用抗菌药物,尽量缩短住院时间均为预防控制MRSA感染的有效措施.

Current status and risk factors for methicillin-resistant Staphylococcus aureusinfections in children

OBJECTIVE To investigate the epidemiology of methicillin-resistant Staphylococcus aureus(MRSA) causing nosocomial infections in hospitalized children so as to provide scientific evidence for the prevention and control of MRSA infections in children.METHODS The clinical data of 259 children who enrolled in pediatric department from Jan 2008 to Dec 2010 were retrospectively analyzed;by means of the univariate analysis,the infection rates were compared and analyzed from 4 aspects including the age,gender,use of antibiotics,and the hospital stay.RESULTS There were totally 259 strains of S.aureus isolated from various clinical specimens obtained from 259 children,among which there were 94 strains of MRSA with the detection rate of 36.3%;of 94 cases of children,there were 46(48.9%) males and 48(51.1%) females;the difference in the rate of MRSA infection between the males and females was not statistically significant;there were 34 cases aged less than 3 years old,46 cases aged between 3 to 7 years of age,and 14 cases aged between 7 to 14 years of age,accounting for 36.2%,48.9%,and 14.9%,respectively,the differences were statistically significant(P<0.05);the children with duration of antibiotic application less then 2 weeks accounted for 29.8%,the patients with more than 2 weeks 70.2%,the difference was statistically significant(P<0.05);the children with the hospital stay less than 2 weeks accounted for 33.3%,the patients with more than 2 weeks 67.0%,the difference was statistically significant(P<0.05).CONCLUSION The MRSA infections in the hospitalized children are closely related to the age,the duration of antibiotics application,and the hospital stay;to actively perform the surveillance of etiology,find then quarantine the cases with MRSA infection in a timely manner,reasonably use antibiotics,and shorten the hospital stay is the effective ways to prevent and control the MRSA infections.