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目的研究耐甲氧西林金黄色葡萄球菌(MRSA)在重症监护病房(ICU)患者鼻腔携带定植情况及其影响因素。方法通过回顾性分析方法,对某医院ICU住院患者鼻腔棉拭子标本的检测结果进行调查与分析。结果2009年7月1日至2010年6月30日期间,该医院检测ICU入院24 h内623例患者鼻腔棉拭子标本检测结果,检出90例MRSA定植阳性,阳性率为14.45%。单因素分析发现,患者高龄、糖尿病、急性肾衰、充血性心衰、近期手术等为MRSA定植的危险因素。多因素分析发现,糖尿病及充血性心衰为ICU病人MRSA定植的独立危险因素。结论该医院ICU入院24 h内的病人鼻腔携带MRSA者占14.45%,这种MRSA定植构成多重耐药感染主要危险因素,抵抗力低下人群是MRSA定植的独立危险因素。
Objective To study the nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) in intensive care unit (ICU) and its influencing factors. Methods The retrospective analysis was used to investigate and analyze the results of nasal swab samples from inpatients with ICU in a hospital. Results From July 1, 2009 to June 30, 2010, the hospital detected the results of nasal swab samples from 623 patients admitted within 24 hours after ICU admission. The positive rate of 90 MRSA colonies was 14.45%. Univariate analysis found that patients with advanced age, diabetes, acute renal failure, congestive heart failure, recent surgery and other risk factors for MRSA colonization. Multivariate analysis found that diabetes and congestive heart failure were independent risk factors for MRSA colonization in ICU patients. Conclusion The intranasal MRSA patients accounted for 14.45% within 24 hours after hospital ICU admission. This MRSA colonization constitutes the main risk factor for multidrug resistance infection. The low resistance population is an independent risk factor for MRSA colonization.