目的 探讨骨科住院患者的金黄色葡萄球菌(staphylococcus aureus,SA)和耐甲氧西林金黄色葡萄球菌(methicillin-resistant staphylococcus aureus,MRSA)定植特点及其与术后手术切口感染(surgical site infections,SSI)的相关性,并分析影响定植的相关因素.方法 采集2020年1月～2022年10月在浙江省立同德医院骨科住院的420例患者的鼻拭子和咽拭子标本,使用聚合酶链反应(polymerase chain reaction,PCR)法检测SA和MRSA阳性定植情况,获取患者的临床资料,采用x2检验分析SA阳性定植与术后SSI的相关性,采用单因素和多因素Logistic回归分析探讨影响SA定植的相关因素.结果 420例患者中,19例患者SA检测阳性,总体SA定植阳性率为4.5％.19例中有17例患者同时呈MRSA检测阳性,MRSA定植阳性率为4.0％.SA定植阳性者与定植阴性者术后发生SSI比较,差异无统计学意义(P＞0.05),SA与术后SSI的发生无明显相关性.单因素Logistic回归分析结果显示,年龄、体重指数(body mass index,BMI)是SA定植的影响因素,多因素Logistic回归分析结果显示,BM1是SA定植的危险因素,BMI越大定植风险越高.年龄是SA定植的保护因素,随着年龄增大SA定植风险降低.结论 骨科住院患者SA阳性定植不会增加术后SSI的风险,术前进行增加患者医疗成本的SA去定植措施是没有必要的.BMI是骨科住院患者SA定植的危险因素,年龄是其保护因素.骨科住院患者SA定植具有区域属性,每个区域需要根据本地域的SA定植流行病学特点制定医疗方案.
Characteristics of SA and MRSA Colonization in Orthopedic Inpatients and their Correlation with Postoperative SSI
Objective To investigate the colonization characteristics of staphylococcus aureus(SA)and methicillin-resistant staphylococcus aureus(MRSA)and their correlation with postoperative surgical site infection(SSI)in orthopedic inpatients,and to ana-lyze the related factors affecting their colonization.Methods Nasal swab and pharyngeal swab samples of 420 patients hospitalized in the Department of Orthopedics,Tongde Hospital of Zhejiang Province from January 2020 to October 2022 were collected.Polymerase chain re-action(PCR)was used to detect the positive colonization of SA and MRSA,and clinical data of patients were obtained.x2 test was used to analyze the correlation between SA positive colonization and postoperative SSI.Univariate and multivariate Logistic regression analysis were used to explore the related factors affecting SA colonization.Results Among 420 patients,19 patients were positive for SA,and the overall SA colonization positive rate was 4.5％.17 patients were positive for MRSA,and the overall MRSA colonization positive rate was 4.0％.There was no statistically significant difference in postoperative SSI between SA colonization positive and SA colonization negative patients(P＞0.05).Thus,there was no significant correlation between SA colonization and the occurrence of postoperative SSI.Univari-ate Logistic regression analysis showed that age and body mass index(BMI)were influencing factors for SA colonization,while multivari-ate Logistic regression analysis showed that BMI was the risk factor for SA colonization,and the higher the BMI,the higher the colonization risk.Age was the protective factor for SA colonization,and the risk of SA colonization decreased with increasing age.Conclusion SA colonization in orthopedic inpatients does not increase the risk of postoperative SSI,and preoperative SA decolonization that increases the patient's medical cost is unnecessary.BMI is the risk factor for SA colonization in orthopedic inpatients,and age is the protective factor.SA colonization of orthopedic inpatients has regional attributes,and each region needs to make medical plans according to its regional SA colonization epidemiological characteristics.
万方数据
维普
