ＩＣＵ的ＭＲＳＡ病人可能无需隔离

缭绕

请问这是哪一年的研究结果？发表在哪儿的？

sandra001

”ＩＣＵ的ＭＲＳＡ病人可能无需隔离“的调查是以“自始至终，医务人员遵守标准的预防措施及手部卫生指南，并对其依从性进行监察。”为前提的，这句话提醒地很好

楚楚

原帖由 鱼禾草 于 2007-11-9 01:25 发表

                               
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      英国伦敦大学医院Ｃｅｐｅｄａ等进行的前瞻性研究结果显示，由于对感染耐甲氧西林金黄色葡萄球菌（ＭＲＳＡ）患者进行隔离并不能减少ＭＲＳＡ的交叉感染，因此，有必要对隔离ＭＲＳＡ感染的ＩＣＵ患者的政 ...

国内单间隔离是基于标准预防措施执行不力。
或许本研究只适用于ICU病房。ICU病房的患者一般病情较重，不能自主活动，同时没有陪伴，因此可以杜绝患者和陪伴这两个传播途径，确实切断医源性传播这条途径就可以避免MRSA的传播。但如果在普通病房，恐怕要另当别论。

一把酸枣

不隔离是有前题的:o 做好标准预防和手卫生的清洁:lol 做不好这2个 隔离也是没用的;P 我支持:P

风子一平

不知国内有几家医院对非暴发医院感染事件时分离出MRSA病人进行过隔离？

如果某家医院发生MRSA引起的暴发医院感染事件，谁敢不隔离MRSA感染的病人？

楼主的文章很有借鉴价值，但注意前提条件。

樵夫

Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study.
Cepeda JA, Whitehouse T, Cooper B, Hails J, Jones K, Kwaku F, Taylor L, Hayman S, Cookson B, Shaw S, Kibbler C, Singer M, Bellingan G, Wilson AP.
Department of Clinical Microbiology, University College London Hospitals, London W1T 4 JF, UK.


BACKGROUND: Hospital-acquired infection due to meticillin-resistant Staphylococcus aureus (MRSA) is common within intensive-care units. Single room or cohort isolation of infected or colonised patients is used to reduce spread, but its benefit over and above other contact precautions is not known. We aimed to assess the effectiveness of moving versus not moving infected or colonised patients in intensive-care units to prevent transmission of MRSA. METHODS: We undertook a prospective 1-year study in the intensive-care units of two teaching hospitals. Admission and weekly screens were used to ascertain the incidence of MRSA colonisation. In the middle 6 months, MRSA-positive patients were not moved to a single room or cohort nursed unless they were carrying other multiresistant or notifiable pathogens. Standard precautions were practised throughout. Hand hygiene was encouraged and compliance audited. FINDINGS: Patients' characteristics and MRSA acquisition rates were similar in the periods when patients were moved and not moved. The crude (unadjusted) Cox proportional-hazards model showed no evidence of increased transmission during the non-move phase (0.73 [95% CI 0.49-1.10], p=0.94 one-sided). There were no changes in transmission of any particular strain of MRSA nor in handwashing frequency between management phases. INTERPRETATION: Moving MRSA-positive patients into single rooms or cohorted bays does not reduce crossinfection. Because transfer and isolation of critically ill patients in single rooms carries potential risks, our findings suggest that re-evaluation of isolation policies is required in intensive-care units where MRSA is endemic, and that more effective means of preventing spread of MRSA in such settings need to be found.

全文见附件

[ 本帖最后由 create_qiao 于 2008-4-7 18:46 编辑 ]

鱼禾草

谢谢乔老师为我找到了该观点的出处

鱼禾草

原帖由 create_qiao 于 2008-4-7 18:42 发表

                               
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Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study.
Cepeda JA, Whitehouse T, Cooper B, Hails J, Jones K, Kwaku F, Tay ...

由于本人英语水平太臭，在此重金;P ;P 寻赏高人翻译一下全文，免得断章取义，误了自己也误了他人呀:handshake :handshake

xiong4222

能自始自终做到标准预防并执行手卫生指南，这可是感控人员梦寐以求的结果啊！

飞舞

病人隔离了，但标准预防和手卫生未认真落实， 隔离其实成了一种形式。

wxyj

关键是手卫生做好，不能只流于形式。

桃子妖妖

很好的资料,谢谢分享哈.如果进一步得到证实,ICU的护士长再不会为床位愁了,呵呵:)

桃子妖妖

请问这一新观点,仅仅是在ICU吗?其它病房的ＭＲＳＡ病人仍需隔离吗??:P

兰兔

医务人员遵守标准的预防措施及手部卫生指南，并对其依从性进行监察，这是所谓不隔离的前提，而标准的预防措施及手部卫生，是阻挡....传播的重要措施。

clarck7

在国内的话，可能不好做到。
因为手卫生依从性低，护士操作了MRS携带者，又操作临近的病人，当然容易传播，所以国内隔离的目的就是阻止病人携带的病原菌传播。
如果隔离起了，隔离病房中的病人少，护士的工作强度相对低些，手卫生依从性可能更高，或许能减少病原菌再次传播的几率，但看英国的手卫生做的很好，隔离当然也就没有意义了。