我国医院获得性耐甲氧西林金黄色葡萄球菌感染危险因素的Meta分析

目的：探讨我国医院获得性耐甲氧西林金黄色葡萄球菌（MRSA）感染的危险因素，为预防决策提供依据。方法检索PubMed、Medline、CNKI、CBM、万方等数据库中发表的关于中国人群MRSA感染危险因素的文献，对MRSA感染的危险因素进行Meta分析，计算合并后危险因素的OR值及95％CI。结果共22篇文献入选本研究，累计病例2312例，对照1931例。 Meta分析结果显示，年龄>60岁（OR=1.45，95%CI：1.02~2.08）、存在基础疾病（OR=2.10，95%CI：1.48~2.96）、低蛋白血症（OR=3.17，95%CI：1.57~6.38）、激素治疗（OR=3.94，95%CI：1.70~9.13）、抗菌药物联合应用（OR=4.77，95%CI：2.74~8.29）、深静脉植入（OR=3.44，95%CI：1.59~7.42）、气管切开（OR=3.22，95%CI：1.43~7.25）、机械通气（OR=1.88，95%CI：1.44~2.44）、留置导尿（OR=2.28，95%CI：1.06~4.90）和鼻胃插管（OR=1.75，95%CI：1.10~2.78）是医院获得性MRSA感染的危险因素。结论目前影响我国人群医院获得性MRSA感染的危险因素包括抗菌药物联合应用、侵入性操作、基础疾病、年龄>60岁、低蛋白血症和激素治疗等。

Meta-analysis on risk factors for hospital-acquired methicillin-resistant Staphylococcus aureus infection in China

Objective To discuss the risk factors of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection, and to provide evidence for prevention decision. Methods The relative researches of MRSA infection in China were retrieved by the internet technology in the Pubmed, Medline, CNKI, CBM and Wanfang databases. Meta-analysis was applied to calculate the pooled odds ratio (OR) and 95%CI. Results A total of 22 publications were included. The cumulative cases and controls were 2 312 and 1 931, respectively. The OR values of different risk factors were as follows:age>60 years (OR=1.45, 95%CI:1.02-2.08) , underlying disease(OR=2.10, 95%CI:1.48-2.96), hypoproteinemia (OR=3.17, 95%CI: 1.57-6.38), hormone therapy (OR=3.94, 95%CI: 1.70-9.13), combined antibiotics (OR=4.77, 95%CI: 2.74-8.29), venous catheter insertion (OR=3.44, 95%CI: 1.59-7.42), tracheotomy(OR=3.22, 95%CI:1.43-7.25), mechanical ventilation(OR=1.88, 95%CI:1.44-2.44), indwelling catheter (OR=2.28, 95%CI: 1.06-4.90) and nasogastric intubation (OR=1.75, 95%CI: 1.10-2.78) . Conclusions The risk factors influencing hospital acquired MRSA infection in China are antibiotic combinations, invasive procedures, underlying disease, age>60 years, hypoproteinemia, hormone therapy and so on.