CAJ | 학술논문

目的：分析重症监护室（ ICU）患者鼻腔定植金黄色葡萄球菌（ SA）与院内感染的关系和安尔碘III鼻腔去定植治疗效果。方法对入院患者行鼻拭子细菌学检测，并观察所有患者医院感染的发生情况。将有SA定植者分为对照组和治疗组，对照组给予常规治疗和护理，治疗组在此基础上再给予安尔碘III鼻腔去定植治疗。观察两组患者鼻腔SA清除率和医院感染的发生情况。结果共751例患者入选本研究，108例发生医院感染，发生率为14．38％。 SA鼻腔定植85例（11．3％），其中耐甲氧西林金黄色葡萄球菌（MRSA）定植者33例（4．4％），MRSA定植患者入院后医院感染发生率为51．5％，明显高于其他类型细菌定植者（P＜0．05）。治疗组鼻腔SA清除率为81．4％，明显高于对照组的42．8％（P＜0．05）；治疗组医院感染发生率为16．3％，明显低于对照组的40．5％（P＜0．05）；MRSA定植患者经去定植治疗以后，医院感染发生率为25．0％，明显低于对照组的76．5％（P＜0．05）。结论 ICU患者中鼻腔MRSA定植者医院感染发生率明显增高，安尔碘III去定植治疗可以提高鼻腔SA清除率，降低医院感染的发生率。
목적：분석중증감호실（ ICU）환자비강정식금황색포도구균（ SA）여원내감염적관계화안이전III비강거정식치료효과。방법대입원환자행비식자세균학검측，병관찰소유환자의원감염적발생정황。장유SA정식자분위대조조화치료조，대조조급여상규치료화호리，치료조재차기출상재급여안이전III비강거정식치료。관찰량조환자비강SA청제솔화의원감염적발생정황。결과공751례환자입선본연구，108례발생의원감염，발생솔위14．38％。 SA비강정식85례（11．3％），기중내갑양서림금황색포도구균（MRSA）정식자33례（4．4％），MRSA정식환자입원후의원감염발생솔위51．5％，명현고우기타류형세균정식자（P＜0．05）。치료조비강SA청제솔위81．4％，명현고우대조조적42．8％（P＜0．05）；치료조의원감염발생솔위16．3％，명현저우대조조적40．5％（P＜0．05）；MRSA정식환자경거정식치료이후，의원감염발생솔위25．0％，명현저우대조조적76．5％（P＜0．05）。결론 ICU환자중비강MRSA정식자의원감염발생솔명현증고，안이전III거정식치료가이제고비강SA청제솔，강저의원감염적발생솔。
Objective To investigate the relationship between nasal colonization of Staphylococcus aureus(SA) and nosocomial infection in intensive care unit(ICU), and observe the therapeutic effect of Anerdian III in nasal decolonizaion. Methods Bacterial cultures were made by means of nasal swabs among inpatients whom the occurrence of nosocomial infection were observed.Patients with SA colonization were randomly divided into two groups:control and treatment.Control group were given regular treatment, and treatment group were administered Anerdian III in addition to regular treatment.Then the clearance rate of SA and the occurrence of nosocomial infection of two groups were observed. Results A total of 751 patients were enrolled, of whom 108(14.4%) were with nosocomial infection and 85(11.3%) with SA nasal colonization. Methicillin resistant Staphylococcus aureus ( MRSA ) was detected in 33 patients (4.4%).The nosocomial infection rate of patients with MRSA colonization was 51.5%, which was significantly higher than those in patients with other bacterial colonization(P<0.05).The SA clearance rate in treatment group was significantly higher than that in control group(81.4% vs.42.8%,P<0.05).The nosocomial infection rate in treatment group was significantly lower than that in control group ( 16 .3% vs. 40.5%,P <0.05).After decolonization treatment,the nosocomial infection rate of patients with MRSA colonization was significantly lower than that in control group(25.0% vs.76.5%,P <0.05). Conclusion The incidence rate of nosocomial infection in patients with MRSA nasal colonization is markedly increased in ICU, and the decolonization treatment by Anerdian III increases the clearance rate of nasal SA and decreases the incidence rate of nosocomial infection.