医务人员手耐甲氧西林葡萄球菌携带调查及药敏分析
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李瑜珍

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R181.3+2

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深圳市科技计划项目(200703189)


Analysis on carrying rate and antimicrobial susceptibility of methicillinresistant Staphylococcus on medical staff's hands
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    摘要:

    目的调查医务人员手耐甲氧西林葡萄球菌(MRS)的携带及药敏情况。 方法随机抽取某院168名医务人员,分别采集其按六步洗手法洗手前后的手部皮肤拭子标本(共336份)进行MRS分离培养和药敏试验。结果医务人员手MRS携带率在洗手前高达66.67%,而洗手后仍有41.07%,但两者比较,差异有显著性(χ2=22.14,P<0.01)。所携带的MRS均为耐甲氧西林凝固酶阴性葡萄球菌(MRCNS),未检出耐甲氧西林金黄色葡萄球菌(MRSA)。检出的MRCNS除对万古霉素敏感、对呋喃妥因耐药率较低外,对 β内酰胺类抗生素的青霉素、氨苄西林、阿莫西林/克拉维酸、头孢噻吩、头孢噻肟表现出高度耐药,耐药率为70.37%~100.00%;对环丙沙星、红霉素、四环素、克林霉素、复方磺胺甲口恶唑的耐药率达42.33%~80.42%;其耐药率显著高于对甲氧西林敏感的葡萄球菌,并表现出多重耐药。结论医务人员手MRS的高携带率应引起广大医务工作者的高度重视。采用六步洗手法洗手有助于减少MRS携带,减少医源性MRS的蔓延和流行。

    Abstract:

    ObjectiveTo investigate the carrying condition and  antimicrobial  susceptibility of methicillinresistant Staphylococcus (MRS) on medical staff's hands.MethodsOne hundred and sixtyeight  medical staffs were selected randomly in a hospital, 336 swabs samples were collected from their hand skin before and after “sixstep” hand washing respectively. The samples were prepared for isolated culture of MRS as well as antimicrobial susceptibility tests. ResultsThe carrying rate of  MRS on medical staffs’ hands was 66.67% and  41.07% before and after hand washing respectively, there was significant difference between the two (χ2=22.14, P<0.01). All of MRS were methicillinresistant Coagulase negative staphylococcus (MRCNS), methicillinresistant Staphylococcus aureus (MRSA) wasn’t found. Except the relatively lower drugresistant rates to vancomycin and nitrofurantoin, drugresistance rates were all high  to  penicillin, ampicillin, amoxicillin/clavulanic acid,cefalotin and cefotaxime(70.37%~100.00%); the resistant rate to ciprofloxacin, erythromycin, clindamycin, trimethoprimsulfamethoxazole was 42.33%~80.42%; The drug resistance rate of MRS was obviously higher than that of methicillinsensitive Staphylococcus, and the multiply drug resistance was observed. ConclusionHigh carrying rates of MRS on medical staff’s hands should be paid more attention. Sixstep hand washing can  reduce the carrying rates of MRS as well as  the spread and prevalence of MRS among hospital.

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李瑜珍,谢懿,何绪屏.医务人员手耐甲氧西林葡萄球菌携带调查及药敏分析[J]. 中国感染控制杂志,2008,7(6):416-418.
LI Yuzhen, XIE Yi, HE Xuping. Analysis on carrying rate and antimicrobial susceptibility of methicillinresistant Staphylococcus on medical staff's hands[J]. Chin J Infect Control, 2008,7(6):416-418.

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  • 收稿日期:2008-06-30
  • 最后修改日期:2008-08-22
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  • 在线发布日期: 2008-11-30
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