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[目的]探讨健康婴儿鼻前庭耐甲氧西林金黄色葡萄球菌(MRSA)定植特点及影响因素。[方法]以符合条件的530例婴儿为研究对象,应用自行设计的问卷调查研究对象的一般资料。于1、2、3、4、5和6月龄时在鼻前庭采集样本并进行细菌培养,观察金黄色葡萄球菌(SA)、MRSA和肺炎链球菌(SP)的定植情况。应用logistic回归分析探讨6月龄时MRSA定植的危险因素。[结果]SA定植率在1月龄时最高(128例,24.2%),并随月龄增加而下降(χ2=47.128,P<0.001);SP定植率则在1月龄时最低(20例,3.8%),并随月龄增加而升高(χ2=52.486,P<0.001);MRSA定植率在1~2月龄时最高(24例,4.5%;15例,2.8%),此后下降并趋于平稳(χ2=6.293,P=0.042)。logistic多元回归分析显示出生体重<2 500 g[OR(95%CI):1.267(1.036~3.754),P=0.042]、环境烟草烟雾暴露[OR(95%CI):1.244(1.084~4.766),P=0.045]、住院史[OR(95%CI):1.539(1.369~6.847),P=0.033]和应用抗生素[OR(95%CI):1.832(1.645~4.021),P=0.019]是影响MRSA定植的独立危险因素。[结论]健康婴儿在出生后前6个月的早期较晚期有较高的MRSA定植率。低出生体重、有住院史、存在环境烟草烟雾暴露和应用抗生素是MRSA定植的独立危险因素,加强医务人员手部卫生和医院消毒、严禁室内吸烟将有助于减少MRSA的定植。
[Objective] To investigate the characteristics and influencing factors of methicillin-resistant Staphylococcus aureus colonization in healthy infants. [Methods] A total of 530 infants who met the criteria were selected as the study objects, and the general data of the subjects were studied by self-designed questionnaire. At 1, 2, 3, 4, 5 and 6 months of age, samples were taken from the nasal vestibule and cultured in vitro. Colonization of Staphylococcus aureus (SA), MRSA and Streptococcus pneumoniae (SP) was observed. Logistic regression analysis was used to explore the risk factors for MRSA colonization at 6 months of age. [Results] The rate of SA colonization was the highest at 1 month (128 cases, 24.2%) and decreased with the increase of age (χ2 = 47.128, P <0.001). The rate of SP colonization was the lowest at 1 month , 3.8%) and increased with the increase of age (χ2 = 52.486, P <0.001). MRSA colonization rate was the highest at 1-2 months (24 cases, 4.5%; 15 cases, 2.8% And tends to be stable (χ2 = 6.293, P = 0.042). Logistic multiple regression analysis showed that birth weight <2,500 g [OR (95% CI): 1.267 (1.036-3.754), P = 0.042] (95% CI: 1.539, 1.369-6.847, P = 0.033) and the use of antibiotics (OR 95% CI 1.832 (1.645-4.02 1) P = 0.019] MRSA colonization of independent risk factors. [Conclusion] Healthy infants have higher colonization rate of MRSA in the early 6 months after birth. Low birth weight, history of hospitalization, presence of environmental tobacco smoke exposure and application of antibiotics are independent risk factors for MRSA colonization. Strengthening hand hygiene and hospital disinfection of medical staff and banning indoor smoking will help to reduce MRSA colonization.