CAJ | 학술논문

目的：了解耐甲氧西林金黄色葡萄球菌（M RS A ）在IC U的定植、分布及其防控效果。方法新进入IC U病房患者即刻采鼻前庭拭子和72 h后符合呼吸道感染指针患者的吸痰导管标本。采用荧光PCR快速检测mecA、nuc基因。并定期对医护人员鼻腔、手等相关环境标本跟踪监测防控。结果 M RS A阳性率检出率：患者鼻前庭拭子为9．9％，吸痰导管为2．7％；医护人员鼻前庭拭子为7．1％、手为4．0％、袖口为4．4％；M RS A阳性医护人员与患者鼻腔采用莫匹罗星擦拭，手加强消毒后M RS A检出率均为0．0％，但每季度医护人员鼻腔M RSA仍有检出。结论 PCR方法阳性率明显高于常规培养方法。鼻腔前庭是M R‐SA的主要定植部位，是主要感染源，手是重要传播途径，监测重症监护室患者鼻腔前庭及医护人员的鼻腔前庭、手是控制M RSA院内感染的重要防控目标。
목적：료해내갑양서림금황색포도구균（M RS A ）재IC U적정식、분포급기방공효과。방법신진입IC U병방환자즉각채비전정식자화72 h후부합호흡도감염지침환자적흡담도관표본。채용형광PCR쾌속검측mecA、nuc기인。병정기대의호인원비강、수등상관배경표본근종감측방공。결과 M RS A양성솔검출솔：환자비전정식자위9．9％，흡담도관위2．7％；의호인원비전정식자위7．1％、수위4．0％、수구위4．4％；M RS A양성의호인원여환자비강채용막필라성찰식，수가강소독후M RS A검출솔균위0．0％，단매계도의호인원비강M RSA잉유검출。결론 PCR방법양성솔명현고우상규배양방법。비강전정시M R‐SA적주요정식부위，시주요감염원，수시중요전파도경，감측중증감호실환자비강전정급의호인원적비강전정、수시공제M RSA원내감염적중요방공목표。
Objective To understand the colonization ,distribution and prevention of methicillin‐resistant Staphylococcus aureus (MRSA) in ICU .Methods The nasal vestibule swabs were immediately taken from new patients in ICU and the sputum suction catheter specimens were collected from the patients conforming to respiratory tract infection at 72 h after entering ICU .The fluores‐cence PCR was adopted to rapidly detect mecA ,nuc gene .The related environment specimens such as nasal cavity and hands in med‐ical staffs were performed the regular tracking monitoring ,prevention and control .Results The MRSA‐detection rates were 9 .9%for nasal vestibule swabs ,2 .7% for sputum suction catheter ;7 .1% for nasal vestibule swabs of medical staffs ,4 .0% for hands and 4 .4% for cuffs;the medical staffs and patient′s nasal cavity with MRSA‐positive adopted mupirocin for scrubing ,MRSA detection rate in hands after reinforce disinfection was 0 .0% ,but nasal cavity MRSA in medical staff was still detected out every quarter . Conclusion The PCR method has significantly higher positive detection rate compared with the conventional culture method .Nasal vestibule is a major colonization site of M RSA and the main infection source of infection ,the hands are the important route of trans‐mission ,monitoring nasal vestibule in ICU patients and medical staffs and hands in medical staffs is important to control MRSA nosocomial infection .