重症监护病房医务人员鼻腔带菌及其耐药性

Nasal carriage and antimicrobial resistance of bacteria in health care workers in an intensive care unit

摘要:

目的探讨重症监护病房（ICU）医务人员鼻腔带菌及其耐药情况，为制订医院感染防控措施提供依据。方法采用棉拭子采样法，对某院2014年4月—2015年3月ICU医务人员鼻腔黏膜进行采样，检测其携带病原菌及其耐药情况。结果共采集450份鼻腔标本，分离病原菌137株，检出率为30.44%。不同性别、年龄、工作岗位、工龄、文化程度的医务人员鼻腔带菌检出率比较，差异均无统计学意义（P＞0.05）；医务人员不同季节鼻腔带菌检出率比较，差异具有统计学意义（P＜0.05）。其中革兰阴性菌82株（占59.85%），以肺炎克雷伯菌（21.16%）、产气肠杆菌（18.98%）为主；革兰阳性菌55株（占40.15%），以金黄色葡萄球菌（18.98%）、表皮葡萄球菌（15.33%）为主。检出38株（27.74%）多重耐药菌。耐甲氧西林金黄色葡萄球菌占7.69%（2/26），耐亚胺培南肺炎克雷伯菌占3.45%（1/29），耐亚胺培南产气肠杆菌占3.85%（1/26）。结论ICU医务人员鼻腔病原菌携带率较高，多重耐药菌检出率高。

Abstract:

ObjectiveTo evaluate nasal carriage and antimicrobial resistance of bacteria in health care workers(HCWs) in an intensive care unit (ICU), and provide basis for making prevention and control measures of healthcareassociated infection(HAI).MethodsFrom April 2014 to March 2015, nasal swabs from HCWs in ICU were collected, carriage and antimicrobial resistance of bacteria were detected.ResultsA total of 450 nasal swab specimens were taken, 137 strains were isolated, isolation rate was 30.44%. There were no significant difference in nasal carriage rates of bacteria in HCWs with different genders, ages, types of work, length of service, and educational level (P>0.05); nasal carriage rates in HCWs at different seasons were significantly different (P<0.05). 82 strains (59.85%) were gramnegative bacteria, the major were Klebsiella pneumoniae （21.16%）and Enterobacter aerogenes（18.98%） ; 55 strains (40.15% ) were grampositive bacteria, the major were Staphylococcus aureus （18.98%）and Staphylococcus epidermidis（15.33%）. 38 (27.74%）strains were multidrugresistant strains. 7.69% （2/26） of Staphylococcus aureus were methicillinresistant strains, 3.45%（1/29）of Klebsiella pneumoniae and 3.85%（1/26）of Enterobacter aerogenes were imipenemresistant strains.ConclusionNasal carriage rate of bacteria and detection rate of multidrugresistant organisms in HCWs in ICU is high.