某儿童医院耐甲氧西林金黄色葡萄球菌分布特征调查

目的调查某儿童医院耐甲氧西林金黄色葡萄球菌(MRSA)的分布特征,为预防和控制儿童MRSA感染提供依据。方法对2011—2015年入住该儿童医院的患儿进行回顾性分析,收集并分析患儿临床资料、分离病原菌、送检标本种类、医院感染情况等。结果 2011—2015年共检出金黄色葡萄球菌(SA)阳性患儿911例(1 108份阳性标本),其中MRSA阳性患儿494例(599份阳性标本),MRSA例数分离率为54.23%(分离率为54.06%);不同性别MRSA例数分离率比较,差异无统计学意义(P0.05);不同年龄组MRSA例数分离率比较,差异有统计学意义(P0.05)。血、穿刺液、分泌物、脓液MRSA分离率分别为68.97%、66.00%、55.81%、54.47%。SA检出率从2011年的0.61%上升至2015年的1.40%,MRSA分离率从2011年的21.74%上升至2015年的75.59%,差异均有统计学意义(均P0.05)。SA、MRSA医院感染发生率从2011年的0.198%,分别上升至2015年的2.697%、2.119%,均呈逐年上升趋势(均P0.05)。结论该儿童医院住院患儿MRSA分离率及医院感染发生率均呈逐年上升,急需加大监管力度,科学合理使用抗菌药物,及时消毒隔离,遏制MRSA在医院环境中的产生和传播。

Distribution characteristics of methicillin resistant Staphylococcus aureus in a children’s hospital

ObjectiveTo investigate the distribution characteristics of methicillin resistant Staphylococcus aureus (MRSA) in a children’s hospital, and provide basis for the prevention and control of MRSA infection in children. MethodsChildren who admitted to a children’s hospital from 2011 to 2015 were analyzed retrospectively, clinical data of children, isolation of pathogens, types of specimens, and healthcare associated infection(HAI) status were analyzed. ResultsFrom 2011 to 2015, a total of 911 children isolated Staphylococcus aureus (SA, 1 108 positive specimens), 494 of whom isolated MRSA (599 positive specimens), 54.23% of children isolated MRSA（isolation rate of specimens was 54.06%）；there was no significant difference in the isolation rate of MRSA between children of different genders（P＞0.05）；isolation rate of MRSA in different age groups was statistically significant（P＜0.05）. Isolation rates of MRSA from blood, puncture fluid, secretion, and pus were 68.97%, 66.00%, 55.81%, and 54.47% respectively. Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40% and 75.59% in 2015 respectively, difference were both significant(both P<0.05). Incidence of SA and MRSA increased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively, both showed an upward trend year by year(both P<0.05). ConclusionIsolation rate of MRSA and incidence of HAI in this children’s hospital increased year by year, it is necessary to intensify management, use antimicrobial agents scientifically and rationally, timely perform disinfection and isolation, so as to curb the emergence and spread of MRSA in hospital settings.