肿瘤化疗患者金黄色葡萄球菌携带状况的调查与分析 FREE

目的调查肿瘤化疗患者鼻前庭、手部金黄色葡萄球菌(SA)携带状况，以加强医院感染预防与控制。方法对某院2008年5-11月在肿瘤化疗科住院的199例患者于入院48 h内及出院前采集鼻前庭和手部标本进行培养、菌种鉴定，并采用K B纸片扩散法以头孢西丁药敏纸片鉴定耐甲氧西林SA（MRSA）。结果199例患者入院时鼻前庭携带SA者22例(11.06%)，携带MRSA者2例(1.01%)；手携带SA者34例(17.09%)，携带MRSA者9例(4.52%)。出院前，鼻前庭携带SA者29例（14.57%），携带MRSA者8例（4.02%）；手携带SA者26例（13.07%），携带MRSA者7例（3.52%）。出院前新增加鼻前庭携带SA者17例（8.54%），携带MRSA者7例（3.52%）；新增加手携带SA者19例（9.55%），携带MRSA者7例（3.52%）。鼻前庭携带SA患者中，出院前MRSA携带率27.59%（8/29)，高于入院时的携带率9.09%（2/22），两者差异有显著性（u=1.65，P＜0.05）。入院时携带SA者中，鼻前庭持续携带率为54.55%，手持续携带率为20.59%，前者明显高于后者（u=2.63，P＜0.01）。结论患者在住院过程中鼻前庭及手可获得SA与MRSA，且鼻前庭携带SA多为持续性，可长时间携带。应加强医务人员的手卫生观念及病区环境的清洁与消毒，以减少SA的携带。

The carriage state of Staphylococcus aureus in tumor patients with chemotherapy FREE

Objective To investigate the nasal and hand carriage state of Staphylococcus aureus （SA） in tumor patients with chemotherapy, so as to strengthen nosocomial infection prevention and control. Methods One hundred and ninety-nine patients in chemotherapy department from May to November 2008 were investigated, samples of patients＇ anterior nares and hands within 48 hours of admission and before discharge were taken, SA were isolated and identified, methieillin-resistant Staphylococcus aureus （MRSA） were detected with cefoxitin disk diffusion method. Results Twenty-two （11.06%） of 199 patients＇ anterior nares carried SA at admission, 2 （1.01%）of which were MRSA; 34 （17. 09%） patients hands carried SA at admission, 9 （4. 52%）of which were MRSA; Before discharge, 29 （14. 57%） patients＇ anterior nares carried SA, 8（4. 02%） of which were MRSA; 26 （13. 07%） patients＇ hands carried SA, 7 （3. 52%）of which were MRSA; The increased nasal carriage of SA before discharge were 17 （8. 54%） cases, 7 （3. 52%） of which were MRSA; The increased hand carriage of SA was 19 cases （9. 55%）, 7 （3.52%） of which were MRSA, the nasal carriage rate of MRSA before discharge was 27. 59% （8/29）, which was higher than the nasal carriage rate of 9. 09% （2/22） at admission, there was significant difference between the two （u = 1.65, P〈0. 05）. Among patients who carried SA at admission, the continued carriage of SA in anterior nares was 54. 55%, in hands was 20. 59%, the former was obviously higher than the latter （u = 2. 63, P〈0. 01）. Conclusion Patients can acquire SA and MRSA during hospitalization, and nasal carriage can be continuous, and last for long time. The awareness of hand hygiene of health care workers and cleaning and disinfection of ward environment should be strengthened.