One size does not fit all: why universal decolonization strategies to prevent methicillin-resistant Staphylococcus aureus colonization and infection in adult intensive care units may be inappropriate for neonatal intensive care units.
One size does not fit all: why universal decolonization strategies to prevent methicillin-resistant Staphylococcus aureus colonization and infection in adult intensive care units may be inappropriate for neonatal intensive care units.
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一个尺寸不符合全部：为什么要预防耐甲氧西林的金黄色葡萄球菌定植和成人重症监护病房感染的普遍非殖民化策略可能不适合新生儿重症监护病房。
DOI：
10.1038/jp.2014.125
复制
发表时间：
2014-09
影响因子：
2.9
通讯作者：
Gallagher, P. G.
中科院分区：
文献类型：
--
作者：
Nelson, M. U.;Bizzarro, M. J.;Dembry, L. M.;Baltimore, R. S.;Gallagher, P. G.
REDUCE MRSA试验（随机评价去殖民化与普遍清除以消除耐甲氧西林金黄色葡萄球菌）是一项在成人重症监护病房（ICU）进行的大型多中心随机对照试验，发现普遍去殖民化比有或无靶向去殖民化的监测和隔离程序更有效，可降低MRSA阳性临床培养率。随后，医疗保健研究和质量机构以及疾病控制和预防中心发布了基于试验方法在ICU中实施普遍去殖民化的方案。在新生儿重症监护室（NICU）中广泛采用这些程序之前，应谨慎行事，特别是涉及洗必泰和莫匹罗星应用的沐浴策略，因为其独特的患者人群（尤其是早产儿）可能会发生不良事件。需要在NICU中进行大型多中心试验，以评估这些策略的有效性，短期和长期安全性以及成本效益，然后才能广泛实施。
The REDUCE MRSA Trial (Randomized Evaluation of Decolonization vs Universal Clearance to Eliminate Methicillin-Resistant Staphylococcus aureus), a large multicenter, randomized controlled trial in adult intensive care units (ICUs), found universal decolonization to be more effective than surveillance and isolation procedures with or without targeted decolonization for reducing rates of MRSA-positive clinical cultures. The Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention subsequently published protocols for implementing universal decolonization in ICUs based on the trial’s methods. Caution should be exercised before widely adopting these procedures in neonatal intensive care units (NICUs), particularly strategies that involve bathing with chlorhexidine and mupirocin application due to the potential for adverse events in their unique patient population, especially preterm infants. Large multicenter trials in the NICUs are needed to evaluate the efficacy, short-and long-term safety, and cost effectiveness of these strategies prior to their widespread implementation.
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DOI：
10.1056/nejmoa1113849
发表时间：
2013-02-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Climo MW;Yokoe DS;Warren DK;Perl TM;Bolon M;Herwaldt LA;Weinstein RA;Sepkowitz KA;Jernigan JA;Sanogo K;Wong ES
通讯作者：
Wong ES
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：
4.5
作者：
Gerber, Susan I.;Jones, Roderick C.;Noskin, Gary A.
通讯作者：
Noskin, Gary A.
影响因子：
3.6
作者：
Lessa, Fernanda C.;Edwards, Jonathan R.;Gorwitz, Rachel J.
通讯作者：
Gorwitz, Rachel J.