METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS - COLONIZATION AND INFECTION IN A LONG-TERM CARE FACILITY
METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS - COLONIZATION AND INFECTION IN A LONG-TERM CARE FACILITY
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DOI：
10.7326/0003-4819-115-6-417
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发表时间：
1991-09-15
影响因子：
39.2
通讯作者：
KAUFFMAN, CA
中科院分区：
文献类型：
--
作者：
BRADLEY, SF;TERPENNING, MS;KAUFFMAN, CA
目的：评估耐甲氧西林金黄色葡萄球菌（MRSA）的定植，传播和感染超过1年的时间在长期护理设施与地方性MRSA。设计：每月监测MRSA定植的鼻孔，会阴，直肠，和伤口。设置：长期护理设施附属于急性护理退伍军人事务医疗中心。患者：所有341例患者在该设施每月监测文化为1 year.Outcome测量：定植和感染MRSA.Main结果：每月MRSA定植率为23% +/- 1.0%，定植最常见的发生在鼻孔和伤口。功能状态差与MRSA定植相关。大多数患者（65%）从未获得MRSA; 25%的患者在入院时或研究开始时已经定植，只有10%的新入院患者在设施中获得MRSA。这些患者获得了几种不同的菌株，其获得模式与机构内通常看到的相似。在1年的过程中，只有9名获得MRSA的患者有相同噬菌体类型的室友;没有明显的聚集，这些患者都没有发生感染。其他九名患者（3%）发展MRSA感染，其中五名患者需要住院治疗，但没有死亡，由于infection.Conclusions：在长期护理设施，我们的研究发生，MRSA是地方性的，感染率低。在这种情况下，需要评估MRSA积极管理的成本效益（广泛筛查MRSA并使用抗菌药物根除）。
Objective: To assess methicillin-resistant Staphylococcus aureus (MRSA) colonization, transmission, and infection over a 1-year period in a long-term care facility with endemic MRSA.Design: Monthly surveillance for MRSA colonization of nares, perineum, rectum, and wounds.Setting: Long-term care facility attached to an acute care Veterans Affairs medical center.Patients: All 341 patients in the facility had monthly surveillance cultures for 1 year.Outcome Measurements: Colonization and infection with MRSA.Main Results: The monthly MRSA colonization rate was 23% +/- 1.0%; colonization occurred most commonly in the nares and wounds. Poor functional status was associated with MRSA colonization. Most patients (65%) never acquired MRSA; 25% of patients were already colonized at admission to the facility or at the start of the study, and only 10% of newly admitted patients acquired MRSA while in the facility. These latter patients acquired several different strains in a pattern of acquisition similar to that generally seen within the facility. In the course of 1 year, only nine patients who acquired MRSA had a roommate with the same phage type; no clustering was evident, and none of these patients developed infection. Nine other patients (3%) developed MRSA infection; five of these patients required hospitalization, but none died as a result of infection.Conclusions: In the long-term care facility in which our study took place, MRSA was endemic, and the infection rate was low. In such settings, the cost effectiveness of aggressive management of MRSA (wide-spread screening for MRSA and eradication with antimicrobial agents) needs to be assessed.