2010年某儿童医院耐甲氧西林金黄色葡萄球菌感染临床分析
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景虹

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R378.1+1

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Methicillinresistant Staphylococcus aureus infection in a children's hospital in 2010
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    摘要:

    目的了解2010年某儿童医院耐甲氧西林金黄色葡萄球菌(MRSA)感染、预后情况及特殊群体儿童与普通儿童MRSA感染的临床特点。方法按常规方法进行细菌的分离与鉴定,细菌药物敏感试验采用纸片扩散(KirbyBaner)法。患儿分组根据其来源及卫生部颁布的《医院感染诊断标准(试行)》进行。结果该儿童医院2010年收治病史完整的MRSA感染病例66例,其中30例为来自上海市儿童福利院(护理院)的救治弃婴。社区感染组以新生儿及接触感染者为主;护理院感染组相关因素包括重度营养不良、术后切口感染、先前住院史、长期卧床/局部压迫等;医院感染组与恶性肿瘤术后化疗、长期经鼻留置胃管、近期手术、气管插管/机械通气有关。平均住院天数为40 d。预后:社区感染组全部好转,治愈出院;护理院感染组有2例死亡,病死率6.67%;医院感染组6例中有3例死亡,占50%。结论来自护理院的患儿与来自社区的普通患儿MRSA感染情况有显著差异,在综合性儿童医院中对此类特殊患者设立独立病房进行隔离治疗,是有效减少社区获得性MRSA与医院获得性MRSA的交叉感染,降低综合性医院医院感染的有效措施。

    Abstract:

    ObjectiveTo investigate the clinical characteristics and prognosis of methicillinresistant Staphylococcus aureus (MRSA) infection in the special group and the normal group of children.MethodsBacterial isolation and identification were performed by routine methods, antimicrobial susceptibility testing was performed by KirbyBauer method. Sick children were grouped according to the source of children and Healthcareassociated Infection Diagnostic Criteria authorized by the Ministry of Health.ResultsSixtysix children with MRSA infection were admitted to the hospital in 2010, 30 of whom were the abandoned sick babies cured in Shanghai Municipal Welfare Home for Children(SMWHC). Communityassociated infection(CAI) group were neonates and contact infected children; infectionrelated factors in SMWHC group included severe malnutrition, surgical site infection, previous hospitalization, longterm bedridden/local compression; healthcareassociated infection (HAI) group was associated with chemotherapy after operation of malignant tumor, longterm nasal feeding, recent operation, tracheal intubation/mechanical ventilation. Average length of hospitalization was 40 days. The prognosis were as follows: All patients in CAI group were improved and discharged; 2 patients in SMWHC group died, mortality was 6.67%; 3 patients in HAI group died, mortality was 50%.ConclusionCharacteristics of MRSA infection in different groups varied significantly, the isolation treatment for the special children in the singleroom ward can reduce the cross infection between the CAMRSA and HAMRSA, as well as to reduce HAI.

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景虹,童海燕,许丽雅.2010年某儿童医院耐甲氧西林金黄色葡萄球菌感染临床分析[J]. 中国感染控制杂志,2012,11(3):182-185.
JING Hong, TONG Haiyan, XU Liya. Methicillinresistant Staphylococcus aureus infection in a children's hospital in 2010[J]. Chin J Infect Control, 2012,11(3):182-185.

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  • 收稿日期:2011-08-25
  • 最后修改日期:2011-11-12
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  • 在线发布日期: 2012-05-30
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