Bed, bath and beyond:: pitfalls in prompt eradication of methicillin-resistant Staphylococcus aureus carrier status in healthcare workers
Bed, bath and beyond:: pitfalls in prompt eradication of methicillin-resistant Staphylococcus aureus carrier status in healthcare workers
复制标题
DOI：
10.1016/j.jhin.2004.06.016
复制
发表时间：
2005-03-01
影响因子：
6.9
通讯作者：
Forster, DH
中科院分区：
文献类型：
--
作者：
Kniehl, E;Becker, A;Forster, DH
对与耐甲氧西林金黄色葡萄球菌（MRSA）感染患者密切接触的热疗工人（HCW）进行MRSA感染筛查。从1995年到2001年，从鼻咽部分离到MRSA。87名医护人员的拭子，在与592名已知MRSA阳性患者接触后1至2周收集。这些HCW退出工作并接受局部治疗。抗生素/防腐剂。他们被建议消毒浴室和个人卫生用品，并清洗床单和枕头。他们进行了长达三个月的成功根除筛查。73（84%）HCW失去了他们的载体状态。14例病例的根除方案失败。其中11例仅在鼻咽部检测到MRSA。拭子（疑似灭活）。在这11例病例中，筛查发现8例为密切家庭接触者的鼻腔定植。环境取样在八个筛选的家庭环境中的七个中检测到污染。当对家庭接触者进行根除治疗，并对家庭表面进行清洁和消毒时，大多数情况下在几周内清除了携带者。然而，当家庭环境受到严重污染时，尽管进行了充分的医疗治疗，根除工作仍需两年时间。因退出工作而未能在第一个疗程后及时持久根除的14例携带者约占70%。损失的工作日这些经验支持这样的假设，即控制措施不应仅限于对长期携带者（HCW以及患者）进行抗生素或防腐剂治疗，还必须包括对家庭进行清洁和消毒。(C)2004年，医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
Heatthcare workers (HCWs) in close contact with patients cotonized with methicillin-resistant Staphylococcus aureus (MRSA) were screened for MRSA acquisition. From 1995 to 2001, MRSA was identified from the nasopharyngeal. swabs of 87 HCWs, collected one to two weeks after contact with 592 known MRSA-positive patients. These HCWs were withdrawn from work and treated with topical. antibiotics/antiseptics. They were advised to disinfect their bathrooms and personal hygiene articles, and to wash bed linen and pillows. They were screened for successful eradication for up to three months. Seventy-three (84%) HCWs lost their carrier status. The eradication regimen failed in 14 cases. In 11 of these MRSA was detected only in later nasopharyngeal. swabs (suspected recolonization). Screening identified nasal, colonization of close household contacts in eight of these 11 cases. Environmental sampling detected contamination in seven out of eight screened home environments. When eradication treatment was applied to household contacts and when household surfaces were cleaned and disinfected, the carriage cleared in most cases within a few weeks. However, when home environments are heavily contaminated, despite adequate medical treatment, eradication took upto two years. Due to withdrawal from work, the 14 carriers without prompt and lasting eradication after the first course of treatment accounted for about 70% of all. lost working days. These experiences support the hypothesis that control measures should not be restricted to antibiotic or antiseptic treatment of long-term carriers (HCWs as well as patients), but must also include cleaning and disinfection of the household. (C) 2004 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.