金黄色葡萄球菌医院感染与外环境关系的研究

目的　分析比较金黄色葡萄球菌医院感染与外环境金黄色葡萄球菌的相关性 ,以了解医院感染病原菌来源。方法　采用分层随机抽样方法抽取深圳市宝安区 15家医院中的 3家医院 (A医院为区级 ,B、C医院为镇级 ) ,连续 5个月收集 3家医院金黄色葡萄球菌的医院感染株、社区感染株、环境株 ,比较 3种来源菌株的耐药谱以及随机引物扩增多态性基因分型 (RAPD)型别之间的差异 ,判断三者之间的相关性。结果　收集金黄色葡萄球菌医院感染株 6株 ,社区感染株 3株 ;在 1190份环境样中共分离到金黄色葡萄球菌 9株 ,环境分离率为 0 76 %。耐药性分析显示环境株、医院感染株对苯唑西林、头孢噻吩、红霉素、复方新诺明的耐药率差异有显著性 (P <0 0 5或P <0 0 1)。RAPD分型分析显示A医院的 4株医院感染株、2株环境株以及 2株社区感染株均属于A型 ;B医院的 1株医院感染株和 1株社区感染株同属C型 ,表明医院感染株与社区感染株、环境株之间存在明显相关性。结论　金黄色葡萄球菌医院感染可能以外源性途径为主。

Research on the correlation between the staphylococcus aureus nosocomial infection and hospital environment

Objective To understand the origin of staphylococcus aureus (SA)nosocomial infection. Methods 3 hospitals from 15 hospitals in Baoan District were selected by randomized multi-stage sampling. SA strains from nosocomial infection, community infection and hospital environment were collected continually for 5 months and the drug resistance and RAPD types of three SA strains were compared. Results 6 strains of SA from nosocomial infection, 3 strains from community infection and 9 strains from the hospital environment were collected. Environment isolated rate was 0.76%. Drug resistance analysis showed that there were significant differences to Oxacillin, Cefalotin, Abomacetin and bactrim between the strains from nosocomial infection and from hospital environment(P<0.05 or P<0.01). RAPD type analysis showed that 4 strains from nosocomial infection, 2 strains from hospital environment and 2 strains from community infection in a hospital belonged to type A and 1 strain from nosocomial infection and 1 strain from community infection in another hospital belonged to type C. These indicated that there was a significant correlation between the SA from the 3 sources. Conclusion The origin of SA nosocomial infection seemed come from hospital environment.