耐甲氧西林金黄色葡萄球菌感染的临床和耐药性

目的通过对重症监护病房(ICU)耐甲氧西林金黄色葡萄球菌( MRSA)感染的分析,探讨正确治疗和防治措施,以预防医院MRSA的发生和流行. 方法对我院ICU 2002年7月1日～2003年1月30日近7个月的追踪观察,对100例MRSA引起的医院感染进行回顾性临床和耐药性分析.结果我院ICU病房7个月内共发生金黄色葡萄球菌感染 104例,其中MRSA感染 100例,占金黄色葡萄球菌感染的95.5%,均全部使用过广谱抗生素,使用≥2种抗生素占43%(OR值1.46,95%CI 1.44 ～3.07),接受＞3种侵入性操作占58%(OR值4.70,95%CI 2.17 ～ 10.19);＞3种基础疾病占51%(OR值2.78,95%CI 1.30～ 5.92). 结论重症监护病房中MRSA的感染率极高,必须引起重视,控制MRSA的感染应积极进行病原学监测、及时发现病例、隔离和治疗患者、合理使用广谱抗生素、严格消毒隔离措施、认真洗手等.

Meticillin-resistant Staphylococcus aureus in ICU:An Analysis on Clinical Features and Resistance

OBJECTIVE To analyze the clinical features and prevalence of nosocomial meticillin-resistant Staphylococcus aureus (MRSA) infection in intensive care unit (ICU). METHODS Retrospective analysis on 100 cases with MRSA infection from July 1, 2002 to Jan 30, 2003 was carried out. RESULTS There were 104 cases with S. aureus infection in ICU during the past 7 months, 95.5% with MRSA infection. Forty three percent of cases treated with more than 2 antibiotics (OR value was 1.46, 95% CI was 1.44-3.07). Fifty-eight percent of patients received more than 3 invasive operations (OR value was 4.70, 95%CI was 2.17-10.19), 51% cases have been suffering from more than 3 basic diseases (OR value was 2.78, 95% CI was 1.30-5.92). CONCLUSIONS Pathogenic monitoring, keeping the patients apart, rational utilization of antibiotics, medical facility sterilization strictly and washing hand are very important for MRSA infections control.