ISOLATION PRECAUTIONS FOR METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS: ELECTRONIC SURVEILLANCE TO MONITOR ADHERENCE
ISOLATION PRECAUTIONS FOR METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS: ELECTRONIC SURVEILLANCE TO MONITOR ADHERENCE
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DOI：
10.4037/ajcc2009467
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发表时间：
2010-01-01
影响因子：
2.7
通讯作者：
Behta, Maryam
中科院分区：
文献类型：
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作者：
Larson, Elaine L.;Cohen, Bevin;Behta, Maryam
美国疾病控制和预防中心最近更新了隔离预防指南，并增加了管理多重耐药微生物的具体建议。然而，这些建议在多大程度上得到遵守尚不得而知。虽然这些建议是基于具有高内部效度的研究，但这些干预措施在临床实践中的有效性也是未知的。以耐甲氧西林金黄色葡萄球菌为例，审查了隔离预防措施在急性护理环境中预防多药耐药微生物引起的感染传播的有效性的证据。尽管缺乏实验数据，但大量描述性和相关性研究以及合理的理论依据强烈表明，屏障预防措施在预防多重耐药微生物引起的感染传播方面发挥着重要作用。然而，仍然存在两个主要问题。首先，工作人员遵守国家关于隔离预防措施的建议，尽管没有充分说明，但似乎是不够的。第二，有效的，可重复的方法进行持续监测的做法，如隔离预防措施是不容易获得的。为决策提供支持的自动监控系统很有希望实现这一目的，可能会节省成本，因此需要更广泛的开发，测试和实施。（American Journal of Critical Care）2010;19：16-27）
The Centers for Disease Control and Prevention recently updated guidelines for isolation precautions and added specific recommendations for the management of multidrug-resistant organisms. However, the extent to which these recommendations are followed is unknown. Although the recommendations are based on studies with high internal validity, the effectiveness of these interventions in clinical practice also is unknown. Evidence of the effectiveness of isolation precautions for preventing transmission of infections caused by multidrug-resistant organisms in acute care settings, with methicillin-resistant Staphylococcus aureus as an example, was reviewed. Despite a lack of experimental data, numerous descriptive and correlational studies and a sound theoretical rationale strongly Suggest that barrier precautions play an important role in the prevention of transmission of infections due to multidrug-resistant organisms. Two major problems, however, still exist. First, staff members' adherence to national recommendations on isolation precautions, although insufficiently described, appears to be inadequate. Second, efficient, reproducible methods for ongoing surveillance of practices such as isolation precautions are not readily available. Automated surveillance systems that provide support for making decisions are promising for this purpose, are likely to result in cost savings, and therefore warrant more widespread development, testing, and implementation. (American Journal of Critical Care. 2010;19:16-27)