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目的研究患者住院期间获得耐甲氧西林金黄色葡萄球菌定植及感染的状况,分析其危险因素。方法采用直接采集病人鼻咽拭子等体表标本,通过细菌学分离培养和鉴定技术,对某三级甲等医院神经内科住院患者进行了筛查和分析。结果在2007年7月~2008年2月,共调查431例患者,检出MRSA定植患者36例(次),占8.35%。有414例患者在入院时未检出耐甲氧西林金黄色葡萄球菌定植,入院后有19例获得该种细菌定植或感染,占入院病人的4.59%。入院后获得耐甲氧西林金黄色葡萄球菌的相关危险因素包括住院时间长,住院次数多,入住过ICU,近期进行手术,使用抗生素以及多种侵入性操作等。多因素分析结果,入院前30 d内或住院期间进行手术及住院期间转床具有统计学意义。结论该医院神经内科患者住院期间MRSA获得与多项因素相关,入院前30 d内或住院期间进行手术及住院期间转床是住院期间MRSA获得的独立危险因素。
Objective To study the status of methicillin-resistant Staphylococcus aureus colonization and infection during hospitalization and analyze its risk factors. Methods The samples of nasopharyngeal swab and other surface specimens were collected directly and screened and analyzed by bacteriological isolation, culture and identification techniques. Results From July 2007 to February 2008, a total of 431 patients were investigated, and 36 cases (times) of MRSA colonization were detected, accounting for 8.35%. 414 patients did not have methicillin-resistant Staphylococcus aureus colonization at admission, and 19 of these patients colonized or infected with the bacteria, accounting for 4.59% of admitted patients. The associated risk factors for acquiring methicillin-resistant Staphylococcus aureus after admission include length of hospital stay, number of hospitalizations, accommodation in the ICU, recent surgery, the use of antibiotics, and a variety of invasive procedures. Multivariate analysis showed that there was statistical significance in the operation and hospitalization during the 30 days before admission or during hospitalization. Conclusions MRSA was associated with a number of factors during inpatient neurosurgery in the hospital. Patients who underwent surgery or hospitalization within 30 days before hospitalization or during hospitalization were independent risk factors for MRSA during hospitalization.