National prevalence of methicillin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006
National prevalence of methicillin-resistant Staphylococcus aureus in inpatients at US health care facilities, 2006
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DOI：
10.1016/j.ajic.2007.10.009
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发表时间：
2007-12-01
影响因子：
4.9
通讯作者：
Jackson, Marguerite
中科院分区：
文献类型：
--
作者：
Jarvis, William R.;Schlosser, Joann;Jackson, Marguerite
背景资料：尽管耐甲氧西林金黄色葡萄球菌（MRSA）是地方性的，几乎所有的美国医疗保健设施，有没有关于MRSA在美国医疗保健facility.Methods的患病率数据：我们进行了一项全国性的MRSA在美国医疗保健设施的住院患者的患病率调查。该调查是制定的，得到了机构审查委员会的批准，然后分发给感染控制和流行病学专业人员协会的所有成员。（APIC）.成员们被要求在2006年10月1日至11月16日期间的一天完成调查，报告MRSA感染或定植和设施的具体information.Results：在1237医院的人员完成了调查。完整的设施数据提供了1187（96%）这些医疗保健设施。所有州都有代表（平均每个州23家机构;范围1-99）。在187，058名住院患者中，受访者报告了8654名MRSA定植/感染患者;总体MRSA患病率为46.3/1000名住院患者（34例感染和12例定植/1000名住院患者）。29%的受访者进行了积极的MRSA监测检测：54%使用常规培养基，38%使用选择性培养基，8%使用聚合酶链反应。提供了7994例（92.4%）MRSA定植/感染患者的详细数据。我们的数据表明，大约70%的分离株更符合卫生保健相关的MRSA（HA-MRSA）比社区相关的MRSA。结论：我们的调查文件MRSA的患病率比以前的研究使用不同的方法。住院患者中的大多数MRSA似乎是HA-MRSA。鉴于大多数机构没有进行主动监测测试，这些是美国医疗保健机构MRSA国家负担的最低估计。
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 health 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.