摘要
目的监测医院ICU医务人员手及环境表面中耐甲氧西林金黄色葡萄球菌(MRSA)的污染情况,为医院采取有效合理的感染控制措施提供依据。方法于2012年6月采用无菌棉签对医院ICU的24名医务人员手及高频接触的物品表面进行采样,用MRSA显色培养皿和PCR技术扩增特征基因nuc和mecA的方法分离、鉴定MRSA,并对分离到的菌株采用法国生物梅里埃公司ATB微生物鉴定药敏系统进行耐药性检测,采用SPSS19.0软件进行数据录入和统计。结果医务人员手MRSA检出率为41.7%,其中保洁员检出率最高,为75.0%;共采集环境标本62份,检出MRSA 7株,检出率为11.3%,其中床单元、医疗设备、公共物品的MRSA检出率差异无统计学意义;所有MRSA对青霉素和苯唑西林的耐药率均为100.0%,但是对米诺环素、喹奴普汀/达福普汀、利福平、替考拉宁和万古霉素敏感率均为100.0%。结论 ICU医务人员手MRSA的检出率较高,环境表面存在MRSA污染,医院应加强教育培训,提高医务人员手卫生意识和提高环境清洁质量。
OBJECTIVE To monitor the contamination of health care workers＇ hands and environmental surfaces with methicillin-resistant Staphylococcus aureus（MRSA）in ICUs so as to provide guidance for the control of infections.METHODS The hands of 24 ICU health care workers and surfaces of high-frequency contacted objects were sampled by using sterile cotton swab in Jun 2012,all the sampled specimens were directly inoculated to MRSA chromogenic culture dish for culture and isolation,the feature genes,nuc and mecA,were amplified by using PCR technique so as to identify the MRSA strains.The drug resistance of the isolated strains was detected by means of ATB microbial identification and drug susceptibility system of bioMérieux,France;the statistical analysis of data was performed with the use of SPSS19.0software.RESULTS The isolation rate of MRSA strains was 41.7%in the health care workers＇ hands,and the isolation rate of MRSA strains was highest（75.0%）in the cleaners＇ hands.Totally 62 environmental specimens were collected,7strains of MRSA were isolated,with the isolation rate 11.3%,and there was no significant difference in the isolation rate of MRSA strains among the bed unit,medical device,and public object.The drug resistance rates of all the MRSA strains to penicillin and oxacillin were100.0%,however,the drug susceptibility rates to minocycline,quinupristin-dalfopristin,rifampicin,teicoplanin,and vancomycin were 100.0%.CONCLUSION The isolation rate of MRSA strains is high in the ICU health care workers′hands,and there is contamination of environmental surfaces with MRSA.It is necessary for the hospital to strengthen the educational training,raise the awareness of hand hygiene of the health care workers,and improve the environmental cleaning quality.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第11期2447-2449,共3页
Chinese Journal of Nosocomiology
基金
浙江省重点科技创新团队基金资助项目(2011R50021)
杭州市科技发展计划基金资助项目(20130733Q32)
关键词
医院感染
耐甲氧西林金黄色葡萄球菌
环境表面
医务人员
保洁员
Nosocomial infection
Methicillin-resistant Staphylococcus aureus
Environmental surface
Health care worker
Environ mentac service worker
作者简介
通信作者：倪晓平，E—mail：hznixp@163．com
