Regional Epidemiology of Methicillin-Resistant Staphylococcus aureus Among Critically Ill Children in a State With Mandated Active Surveillance.
Regional Epidemiology of Methicillin-Resistant Staphylococcus aureus Among Critically Ill Children in a State With Mandated Active Surveillance.
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DOI：
10.1093/jpids/piv050
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发表时间：
2016-12
影响因子：
3.2
通讯作者：
Centers for Disease Control and Prevention, Prevention Epicenters Program
中科院分区：
文献类型：
--
作者：
Lyles RD;Trick WE;Hayden MK;Lolans K;Fogg L;Logan LK;Shulman ST;Weinstein RA;Lin MY;Centers for Disease Control and Prevention, Prevention Epicenters Program
理论上，对耐甲氧西林金黄色葡萄球菌 (MRSA) 的主动监测可以通过识别所有 MRSA 定植患者并对他们采取接触预防措施来减少 MRSA 传播。 2007 年 10 月，伊利诺伊州强制要求在所有重症监护病房（包括新生儿重症监护病房 (NICU) 和儿科重症监护病房 (PICU)）进行主动 MRSA 监测。我们评估了该法律颁布后一个大都市地区的 MRSA 趋势。芝加哥拥有 NICU 或 PICU 的医院被招募来进行 8 项单日点患病率调查，这些调查在 2008 年 6 月至 2011 年 7 月期间每年进行两次，然后在 2012 年至 2013 年每年进行一次。对所有患者的样本进行 MRSA 培养（新生儿的鼻子和脐部，儿科患者的鼻子和腹股沟）。还获得了医院报告的入院 MRSA 筛查结果。使用肉汤富集、显色琼脂和标准验证方法对点流行培养物进行 MRSA 筛查。所有符合条件的医院 (N = 10) 均参与其中（10 个 NICU、6 个 PICU）。据医院报告，入院时遵守国家规定的 MRSA 筛查的比例很高（NICU 为 95%，PICU 为 94%）。根据系列点患病率调查，NICU 和 PICU 中 MRSA 的总体患病率分别为 4.2%（2101 例中的 89 例）和 5.7%（632 例中的 36 例）。 NICU 中的 MRSA 定植率没有变化（同比风险比 [RR]，0.93 [95% 置信区间 (CI)，0.78–1.12]；P = .45），而 PICU 中的 MRSA 定植率呈上升趋势（RR，1.25 [95% CI，0.72–2.12]；P = .053）。我们估计 NICU 和 PICU 中 MRSA 阳性患者分别有 81% 和 40% 新感染 MRSA。在一个强制进行 MRSA 监测的地区，我们发现 NICU 和 PICU 患者中 MRSA 定植和获得率持续保持不变。
In theory, active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) reduces MRSA spread by identifying all MRSA-colonized patients and placing them under contact precautions. In October 2007, Illinois mandated active MRSA surveillance in all intensive care units, including neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs). We evaluated MRSA trends in a large metropolitan region in the wake of this law. Chicago hospitals with a NICU or PICU were recruited for 8 single-day point prevalence surveys that occurred twice-yearly between June 2008 and July 2011 and then yearly in 2012 to 2013. Samples from all patients were cultured for MRSA (nose and umbilicus for neonates, nose and groin for pediatric patients). Hospital-reported admission MRSA-screening results also were obtained. Point prevalence cultures were screened for MRSA by using broth enrichment, chromogenic agar, and standard confirmatory methods. All eligible hospitals (N = 10) participated (10 NICUs, 6 PICUs). Hospital-reported adherence to state-mandated MRSA screening at admission was high (95% for NICUs, 94% for PICUs). From serial point prevalence surveys, overall MRSA prevalences in the NICUs and PICUs were 4.2% (89 of 2101) and 5.7% (36 of 632), respectively. MRSA colonization prevalences were unchanged in the NICUs (year-over-year risk ratio [RR], 0.93 [95% confidence interval (CI), 0.78–1.12]; P = .45) and trended toward an increase in the PICUs (RR, 1.25 [95% CI, 0.72–2.12]; P = .053). We estimated that 81% and 40% of MRSA-positive patients in the NICUs and PICUs, respectively, had newly acquired MRSA. In a region with mandated active MRSA surveillance, we found ongoing unchanged rates of MRSA colonization and acquisition among NICU and PICU patients.
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影响因子：
9.4
作者：
Nakamura, Mari M.;McAdam, Alexander J.;Lee, Grace M.
通讯作者：
Lee, Grace M.
影响因子：
4.5
作者：
Milstone AM;Song X;Coffin S;Elward A;Society for Healthcare Epidemiology of America's Pediatric Special Interest Group
通讯作者：
Society for Healthcare Epidemiology of America's Pediatric Special Interest Group
影响因子：
158.5
作者：
Huang, Susan S.;Septimus, Edward;Platt, Richard
通讯作者：
Platt, Richard
影响因子：
120.7
作者：
Harris, Anthony D.;Pineles, Lisa;Morgan, Daniel J.
通讯作者：
Morgan, Daniel J.
影响因子：
4.5
作者：
Popoola, Victor O.;Budd, Alicia;Milstone, Aaron M.
通讯作者：
Milstone, Aaron M.