Risk factors for the transmission of methicillin-resistant Staphylococcus aureus in an adult intensive care unit:: Fitting a model to the data
Risk factors for the transmission of methicillin-resistant Staphylococcus aureus in an adult intensive care unit:: Fitting a model to the data
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DOI：
10.1086/338568
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发表时间：
2002-02-15
影响因子：
6.4
通讯作者：
Austin, DJ
中科院分区：
文献类型：
--
作者：
Grundmann, H;Hori, S;Austin, DJ
当耐甲氧西林金黄色葡萄球菌（MRSA）感染在重症监护室发生高度流行时，对交叉传播的数量、感染的风险因素以及感染控制程序的相对有效性知之甚少。进行了一项队列研究，以确定与可能是交叉传播结果的病例相关的暴露（即，成簇发生且具有不可区分的MRSA宏观限制性图谱）。将一个简单的随机模型拟合到确定的数据，可以预测感染控制措施的有效性。暴露于相对人员赤字（调整后的比率，1.05独立; 95%置信区间，1.02-1.09）是与潜在传播显着相关的唯一因素（P =.001）。据预测，在遵守手部卫生政策方面提高12%可能会弥补工作人员短缺，并在过度拥挤、共同护理和高工作量期间防止传播，但这很难实现。
Little is known about the amount of cross-transmission, the risk factors for infection, and the relative effectiveness of infection control procedures when methicillin-resistant Staphylococcus aureus (MRSA) infection occurs at highly endemic levels in intensive care units. A cohort study was done to identify exposures associated with cases that likely were the result of cross-transmission (i.e., occurring in clusters and with indistinguishable MRSA macrorestriction profiles). Fitting a simple stochastic model to the ascertained data allowed prediction of the effectiveness of infection control measures. Exposure to relative staff deficit (adjusted rate ratio, 1.05 independent; 95% confidence interval, 1.02-1.09) was the only factor significantly associated with potential transmission (P =.001). It was predicted that a 12% improvement in adherence to hand-hygiene policies might have compensated for staff shortage and prevented transmission during periods of overcrowding, shared care, and high workload but that this would be hard to achieve.