某三级甲等医院心外科手术切口耐甲氧西林金黄色葡萄球菌医院感染调查与分析

目的 调查2011年10-11月某三级甲等医院心外科3例手术患者术后发生耐甲氧西林金黄色葡萄球菌(MRSA)医院感染的原因并及时干预,避免医院感染暴发流行.方法 根据医院感染监测数据直报系统提示有可能发生医院感染,医院成立调查小组,开展医院感染流行病学调查,对相关科室及环节进行调查后采取相应控制措施.结果 2011年心外科发生5例手术切口感染患者,分别在不同的病房及3个治疗组,两例患者检出MRSA,两例患者检出阴沟肠杆菌,1例检出多种病原菌；2011年1-11月切口感染率为0.73％,2010年为0.13％,2009年为0.27％,3年手术切口感染率经卡方检验,差异无统计学意义,该次心外科手术切口感染事件不属于疑似医院感染暴发；但是调查中发现隐患,医院高度重视,立即整改.结论 使用医院感染监测数据直报系统提高监测灵敏度,干预措施有效,消除隐患,避免医院感染的暴发流行,心外科未发现新发手术切口MRSA感染病例.

Investigation and analysis of cardiac surgery incision infected with methicillin-resistant Staphylococcus aureusin a class three hospital

OBJECTIVE TO investigate the causes of methicillin-resistant Staphylococcus aureus(MRSA) infections in 3 patients undergoing cardiac surgery from Oct to Nov 2011 in a class three hospital so as to propose the interventions and avoid the prevalence of nosocomial infections.METHODS According to the direct reporting system of hospital infection surveillance data which indicated the nosocomial infections,the hospital set up an investigation team to carry out the epidemiological investigation,the corresponding control measures were taken after investigating relevant departments and links.RESULTS There were 5 patients with surgical incision infections in cardiac surgery department in 2011,which divided respectively in different wards and three treatment groups;two patients were detected with MRSA,two patients with Enterobacteria cloacae,and one patient with a variety of pathogens;the incision infection rate was 0.73% in Jan-Oct 2011,0.13% in 2010,and 0.27% in 2009,the chi-square test showed that there was no statistical difference in the incision infection rate during the three years,though the incidentce of cardiac surgery infections was not regarded as an outbreak of suspected nosocomial infections,yet there was hidden danger in the investigation,which should be attached great importance to and taken immediate rectification.CONCLUSION The direct reporting system for nosocomial infection surveillance data can improve the monitoring sensitivity,the interventions are effective to eliminate the hidden dangers and prevent the prevalence of nosocomial infections,and there is no new onset of surgical incision with MRSA infection.