MRSA patients: proven methods to treat colonization and infection
MRSA patients: proven methods to treat colonization and infection
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DOI：
10.1016/s0195-6701(01)90005-2
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发表时间：
2001-08-01
影响因子：
6.9
通讯作者：
Boyce, JM
中科院分区：
文献类型：
--
作者：
Boyce, JM
耐甲氧西林金黄色葡萄球菌（MRSA）感染在许多医院继续引起严重的院内感染。用于控制这些感染传播的措施包括持续进行实验室监测，将定植和感染患者隔离，使用屏障预防措施以及洗手和洗手消毒。培养获得MRSA的高风险住院患者可以促进定植患者的检测和分离。根除MRSA鼻腔定植感染患者和医护人员也已作为控制措施，与不同的成功。根除与流行病学有关的卫生保健工作者的MRSA鼻腔载体已在许多场合用于控制疫情。试图根除MRSA在受感染患者中的定植已被证明是困难的。在过去60年中测试的40多种不同的去殖民化方案中，局部鼻内应用莫匹罗星软膏已被证明是最有效的。然而，鼻内应用莫匹罗星在消除在多个身体部位携带生物体的患者的定植方面效果有限。此外，由于病人的非殖民化实际上总是与其他控制措施结合使用，因此很难确定其效力。由于耐甲氧西林金黄色葡萄球菌主要通过卫生保健工作者的手传播，因此应更加重视改善卫生保健人员的手卫生习惯。对于感染MRSA的患者，万古霉素仍然是首选药物。(C) 2001医院感染学会。
Methicillin-resistant Staphylococcus aureus (MRSA) infections continue to cause serious nosocomial infections in many hospitals. Measures used to control the spread of these infections include ongoing laboratory-based surveillance, placing colonized and infected patients in isolation, use of barrier precautions and handwashing and hand antisepsis. Culturing hospitalized patients at high risk of acquiring MRSA can facilitate detection and isolation of colonized patients. Eradicating MRSA nasal colonization among affected patients and healthcare personnel has also been as a control measure, with variable success. Eradicating MRSA nasal carriage from epidemiologically-implicated healthcare workers has been used on a number of occasions to control outbreaks. Attempts to eradicate MRSA colonization among affected patients has proven difficult. Of more than 40 different decolonization regimens that have been tested during the last 60 years, topical intranasal application of mupirocin ointment has proven to be the most effective. However, intranasal application of mupirocin has limited effectiveness in eradicating colonization in patients who carry the organism at multiple body sites. Furthermore, because decolonization of patients has virtually always been used in combination with other control measures, its efficacy has been difficult to determine. Because MRSA is transmitted primarily on the hands of healthcare workers, greater emphasis should be given to improving hand hygiene practices among health personnel. For patients infected with MRSA, vancomycin remains a drug of choice. (C) 2001 The Hospital Infection Society.