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目的了解天津市医疗机构医护人员鼻前庭部带菌情况及其耐药性。方法采用现场采样、细菌分离鉴定技术和药敏试验方法,对天津市医疗机构部分医护人员鼻前庭带菌情况及其耐药性进行研究。结果 1 085名医护人员鼻前庭带菌率为72.53%,其中女性组带菌率显著低于男性组,低学历组带菌率低于其他两组,春夏季带菌率明显低于秋季。检出的908株致病菌中,革兰阴性菌269株,革兰阳性菌639株,革兰阴性菌耐药性最高的是氨苄西林(82.90%),其次是头孢唑林(50.93%)、四环素(21.56%)和头孢噻肟(15.61%),对左氧氟沙星、诺氟沙星和庆大霉素等耐药率较低。革兰阳性菌总体耐药率为78.40%,89株金黄色球葡萄菌中,12株为耐甲氧西林金黄色葡萄球菌(MRSA),7株金黄色葡萄球菌对万古霉素耐药。结论天津市医疗机构医护人员鼻前庭带菌情况严重,且对主要抗菌药物耐药率较高,应加强医护人员鼻前庭卫生清洁,减少由鼻前庭带菌所致医院感染的发生。
Objective To understand the situation of nasal vestibular department of medical staffs in Tianjin and their drug resistance. Methods Field sampling, bacterial isolation and identification techniques and susceptibility testing methods were used to study the nasal vestibular infection and drug resistance of medical staff in Tianjin medical institutions. Results The rate of nasal vestibular infection in 1 085 medical staffs was 72.53%. The carrier rate in female group was significantly lower than that in male group, and the carrier rate in low-education group was lower than that in the other two groups. The carrying rate in spring and summer was significantly lower than that in autumn. Of the 908 pathogens detected, 269 were gram-negative bacteria and 639 gram-positive bacteria. Ampicillin (82.90%) was the most resistant to gram-negative bacteria, followed by cefazolin (50.93%), , Tetracycline (21.56%) and cefotaxime (15.61%). The resistance rate to levofloxacin, norfloxacin and gentamicin was low. Gram-positive bacteria overall resistance rate was 78.40%, 89 strains of Staphylococcus aureus, 12 strains of methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus 7 vancomycin-resistant. Conclusion Medical staff in Tianjin medical institutions have severe nasal discharge and severe resistance to major antimicrobial agents. Sanitation should be strengthened to reduce the incidence of nosocomial infections caused by nasal vestibular infection.