CAJ | 학술논문

目的：调查某院神经外科重症监护室（NSICU）耐甲氧西林金黄色葡萄球菌（MRSA）医院感染暴发的原因。方法采用前瞻性和回顾性调查相结合的方法，对2014年6月15—28日某院 NSICU 发生的8例下呼吸道MRSA感染患者进行流行病学调查。结果2014年6月15—28日该院 NSICU 患者医院 MRSA 下呼吸道感染罹患率为22．86％，该期间住院患者临床标本、鼻前庭标本及环境卫生学标本共分离 MRSA 16株，脉冲场凝胶电泳（PFGE）结果证实此次暴发为2个 MRSA 亚型感染；危险因素分析显示，住 ICU 时间长及使用支气管镜吸痰是 MRSA 下呼吸道感染的危险因素。结论推断 NSICU 支气管镜污染是此次 MRSA 医院感染暴发传播的关键因素。
목적：조사모원신경외과중증감호실（NSICU）내갑양서림금황색포도구균（MRSA）의원감염폭발적원인。방법채용전첨성화회고성조사상결합적방법，대2014년6월15—28일모원 NSICU 발생적8례하호흡도MRSA감염환자진행류행병학조사。결과2014년6월15—28일해원 NSICU 환자의원 MRSA 하호흡도감염리환솔위22．86％，해기간주원환자림상표본、비전정표본급배경위생학표본공분리 MRSA 16주，맥충장응효전영（PFGE）결과증실차차폭발위2개 MRSA 아형감염；위험인소분석현시，주 ICU 시간장급사용지기관경흡담시 MRSA 하호흡도감염적위험인소。결론추단 NSICU 지기관경오염시차차 MRSA 의원감염폭발전파적관건인소。
Objective To investigate the causes of an outbreak of healthcare-associated infection with methicillin-resist-ant Staphylococcus aureus (MRSA)in a neurosurgical intensive care unit(NSICU).Methods Epidemiological investigation on 8 patients with lower respiratory tract infection (LRTI)in a NSICU between June 15 and June 28,2104 were performed by combination methods of prospective and retrospective survey.Results The attack rate of MRSA LRTI in NSICU patients was 22.86%,a total of 16 MRSA isolates were detected from patients’clinical specimens,nasal vestibule,as well as hospital surroundings during the period,pulsed-field gel electrophoresis (PFGE)result revealed that infection outbreak was caused by two subtypes of MRSA;risk factors analysis showed that long length of stay in ICU and aspiration of spu-tum through bronchoscopy were risk factors for MRSA LRTI.Conclusion Contamination of bronchoscope was the key factor for this epidemic spread of healthcare-associated MRSA infection.