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来源：[AJIC]《美国感染控制杂志》卷35 ， 10期， 631-637页（ 2007年12月）
美国住院病人MRSA现患调查（2006年） 【摘要】
作者：略
背景 尽管耐甲氧西林金黄色葡萄球菌（ MRSA ）正在美国所有的卫生保健机构发生，但仍然没有MRSA感染的患病数据。
方法 我们进行一项美国卫生保健机构住院患者MRSA感染的全国调查。这项统计调查是在机构审查委员会批准的医院内，由APIC的专业人士进行。调查要求在2006年10月1日至11月16日期间，采集一天内的调查数据。报告MRSA感染或定殖的病人数目和机构特定信息。
结果 工作人员在1237家医院完成调查。提供完整机构信息数据的有1187家 （ 96 ％ ） ，涵盖了所有的州（均值， 23家/州;范围， 1-99 ） 。共计187058住院病人中，报告8654例 MRSA感染/定植。整体MRSA感染的现患率为46.3 ‰。（1000名住院病人中，有34感染和12 定植） 。主动监测测试MRSA感染的机构有29 ％，其中， 54 ％用常规培养基，38 ％用选择性培养基， 8 ％用PCR（聚合酶链反应）。提供完整病例数据的有7994例 （ 92.4 ％ ） 。调查资料显示，约70 ％的病例采取了隔离措施。与社区MRSA感染相比，该结果与医院相关MRSA感染病例更为符合。
结论 该调查结果显示，MRSA感染的现患率比过去采用各种方法的研究结果高得多。既往对全美卫生机构的MRSA状况存在低估。MRSA感染病例主要来源于不执行主动监测试验的医疗机构中的住院病人的院内获得。
附原文摘要：
National prevalence of methicillin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006
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 he alth 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.
[ 本帖最后由 胡杨 于 2008-7-24 11:15 编辑 ] |
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