2006年美国医疗机构住院病人中MRSA的流行现况 （07年12月AJIC）

David

American Journal of Infection Control
Volume 35, Issue 10, December 2007, Pages 631-637
Special article

National prevalence of methicillin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006
2006年美国医疗机构住院病人中MRSA的流行现况

William R. Jarvis MDa, , , JoAnn Schlosser MAb, Raymond Y. Chinn MDc, Samantha Tweeten MPH, PhDd and Marguerite Jackson PhD, RNe
aJason and Jarvis Associates, Hilton Head Island, SC
bAssociation for Professionals in Infection Control and Epidemiology, Inc., Washington, DC
cSharp Memorial Hospital, San Diego, CA
dCounty of San Diego Health and Human Services Agency, San Diego, CA
eUniversity of California San Diego School of Medicine, San Diego, CA

Available online 6 December 2007.



Background
Despite methicillin-resistant Staphylococcus aureus (MRSA) being endemic in virtually all US health care facilities, there are no data on the prevalence of MRSA in US health care facilities.

Methods
We conducted a national prevalence survey of MRSA in inpatients at US health care facilities. The survey was developed, received institutional review board approval, and then distributed to all members of the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC). Members were asked to complete the survey on one day during the period October 1 to November 16, 2006, reporting the number of inpatients with MRSA infection or colonization and facility-specific information.

Results
Personnel at 1237 hospitals completed the survey. Complete facility data were provided for 1187 (96%) of these health care facilities. All states were represented (mean, 23 facilities per state; range, 1-99). Respondents reported 8654 MRSA-colonized/infected patients in 187,058 inpatients; the overall MRSA prevalence rate was 46.3 per 1000 inpatients (34 infections and 12 colonizations per 1000 inpatients). Active MRSA surveillance testing was conducted by 29% of respondents: 54% used routine media, 38% used selective media, and 8% used polymerase chain reaction. Detailed data were provided on 7994 (92.4%) MRSA-colonized/infected patients. Our data suggest that approximately 70% of isolates were more consistent with health care-associated MRSA (HA-MRSA) than community-associated MRSA.

Conclusion
Our survey documents a much higher MRSA prevalence rate than previous studies using different methodologies. The majority of MRSA in inpatients appears to be HA-MRSA. Given that most facilities did not perform active surveillance testing, these are minimum estimates of the national burden of MRSA in US health care facilities.

右手心

个研究很有意思，我想这足以引起我们院感人员对MRSA的监控。既然美国总发病率都达到了千分之46.3，估计我国会更高。
我们医院目前正在监测我院的 HA-MRSA发病率。