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| 某综合性中医院2018~2020年耐甲氧西林金黄色葡萄球菌分布特点和医院感染监测情况分析 |
| Analysis of distribution characteristics and nosocomial infection surveillance of methicillin-resistant Staphylococcus aureus in a general traditional Chinese medicine hospital from 2018 to 2020 |
| 投稿时间：2021-06-22 |
| DOI：10.3969/j.issn.1000-0399.2022.02.023 |
| 中文关键词: 耐甲氧西林金黄色葡萄球菌 医院感染 监测分析 危险因素 |
| 英文关键词: Methicillin resistant Staphylococcus aureus Nosocomial infection Monitoring and analysis Risk factor |
| 基金项目:安徽省自然科学基金（项目编号：1908085QC90） |
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| 中文摘要: |
| 目的 了解某综合性中医院耐甲氧西林金黄色葡萄球菌（MRSA）的分布特点及医院感染情况，为多重耐药菌医院感染控制工作提供依据。方法 回顾性分析安徽中医药大学第一附属医院2018~2020年住院的166 115例患者检出的MRSA监测资料，将患者分为MRSA医院感染组（130例）和非MRSA医院感染组（446例）。采用单因素和多因素logistic回归分析患者MRSA医院感染的分布特点及危险因素。结果 2018~2020年住院患者共检出MRSA 576株，总检出率为34.95%，经趋势χ2检验，MRSA检出率呈逐年下降趋势（χ2=20.089，P<0.001）。MRSA菌株主要来源是痰（52.95%）和咽拭子（15.97%）；分离出的MRSA主要集中在神经外科（49.83%）、肾病科（7.64%）；分离出的MRSA菌株主要分布在冬季（27.95%）、春季（27.43%）。3年来，共有130例患者发生MRSA医院感染，MRSA总的医院感染发病率为0.78‰。2018~2020年MRSA医院感染发病率分别为0.68‰、0.74‰、0.96‰，经趋势χ2检验，MRSA医院感染发病率随年份增加的趋势无统计学意义（χ2=2.508，P=0.113）。单因素分析结果显示，MRSA医院感染组与非MRSA医院感染组在年龄、住院时间、基础疾病、侵入性操作4个方面比较，差异均有统计学意义（P<0.05）。多因素分析显示，年龄、住院时间和有侵入性操作3个因素是患者MRSA医院感染的危险因素（P<0.05）。结论 通过对医院MRSA分布及医院感染情况进行监测和分析，能够及早发现其易感高危人群和危险因素，及时准确地掌握其分布和感染变化情况，对指导临床做好多重耐药菌感染防控工作具有重要的意义。 |
| 英文摘要: |
| Objective To understand the distribution characteristics of methicillin-resistant Staphylococcus aureus(MRSA) and nosocomial infection of MRSA in a general traditional Chinese medicine hospital, so as to provide the evidence for nosocomial infection control of multidrug-resistant bacteria. Methods Surveillance data of MRSA from 166 115 inpatients in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were analyzed retrospectively from 2018 to 2020. The patients were divided into MRSA nosocomial infection group and non-MRSA nosocomial infection group. Single factor and multiple factor logistic regression analysis were used to analyze the risk factors of MRSAnosocomial infection.Results A total of 576 strains of MRSA were detected from 2018 to 2020, and the total detection rate of MRSA was 34.95%. By the Chi-square trend test, the detection rate of MRSA showed a gradual downward trend(χ2=20.089, P<0.001). The main sources of MRSA were sputum (52.95%) and pharynx swab (15.97%). The main MRSA isolated from different departments were neurosurgery (49.83%) and nephrology (7.64%). The isolates of MRSA were mainly in winter (27.95%) and spring (27.43%). A total of 130 patients developed MRSA nosocomial infection in the past three years, and the total incidence of nosocomial infection in MRSA was 0.78‰. From 2018 to 2020, the incidence of MRSA nosocomial infection was 0.68‰, 0.74‰ and 0.96‰ respectively, which showed that the incidence of MRSA nosocomial infection increased with the year without statistical significance by the Chi-square trend test(χ2=2.508,P=0.113).Univariate analysis showed that there were significant differences in age, length of stay, basic diseases and invasive operation between MRSA nosocomial infection group and MRSA non-nosocomial infection group(P<0.05). Multivariate analysis showed that age, length of stay and invasive operation were independent risk factors of MRSA nosocomial infection(P<0.05).Conclusions Through the monitoring and analysis of the distribution of MRSA and nosocomial infection in hospital, we can find its susceptible high-risk groups and risk factors as soon as possible, and grasp its distribution and infection changes timely and accurately, which is of great significance to guide clinical prevention and control of multidrug-resistant bacterial infection. |
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