Qiao Fu, Huang Wenzhi, Cai Lin, Zong Zhiyong, Yin Weijia
1 Infection Prevention and Control Department, West China Hospital, Sichuan University, Chengdu, China.
2 Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.
J Int Med Res. 2018 Sep;46(9):3698-3708. doi: 10.1177/0300060518777812. Epub 2018 Jun 18.
Objective This study was performed to determine the prevalence and risk factors associated with nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization upon intensive care unit (ICU) admission and during the ICU stay in mainland China. Methods A prospective observational study was performed in a 50-bed general ICU of a 4300-bed teaching hospital in China from 2011 to 2013. Nasal swabs for MRSA detection were obtained upon ICU admission and at discharge for patients having stayed in the ICU for longer than 3 days. Results In total, 115 patients (4.1%; 95% confidence interval [CI], 3.4-4.9) were already colonized with MRSA on ICU admission, and another 185 patients (10.7%; 95% CI, 9.3-12.2) acquired MRSA during their ICU stay. Development of an MRSA infection was significantly more likely in patients with than without MRSA colonization on ICU admission (odds ratio [OR], 2.8; 95% CI, 1.1-7.3). Patients who acquired MRSA had significantly prolonged lengths of stay in the ICU (23.3 days) and higher hospital bills (135,171 RMB; about 19,590 USD) than those who tested negative for MRSA. Conclusion The MRSA colonization rate among ICU patients in mainland China is high. Patients with MRSA-positive nasal swabs are more likely to develop MRSA infections.
目的 本研究旨在确定中国大陆重症监护病房（ICU）入院时及ICU住院期间耐甲氧西林金黄色葡萄球菌（MRSA）鼻腔定植的患病率及相关危险因素。方法 2011年至2013年在中国一家拥有4300张床位的教学医院的50张床位的综合ICU进行了一项前瞻性观察研究。对入住ICU的患者入院时及入住ICU超过3天的患者出院时采集鼻腔拭子检测MRSA。结果 共有115例患者（4.1%；95%置信区间[CI]，3.4 - 4.9）在入住ICU时已被MRSA定植，另有185例患者（10.7%；95% CI，9.3 - 12.2）在ICU住院期间获得了MRSA。入住ICU时已被MRSA定植的患者发生MRSA感染的可能性显著高于未被定植的患者（优势比[OR]，2.8；95% CI，1.1 - 7.3）。获得MRSA的患者在ICU的住院时间显著延长（23.3天），且住院费用高于MRSA检测阴性的患者（135,171元人民币；约19,590美元）。结论 中国大陆ICU患者中MRSA定植率较高。鼻腔拭子MRSA阳性的患者更易发生MRSA感染。
