Zulian C, Descamps P, Samyn B, Lemerle J P, Gaillot O
Hôpital Boucicaut, Paris, France.
Pathol Biol (Paris). 1999 May;47(5):445-8.
Nosocomial infections are an important cause of morbidity and mortality. Methicillin resistant Staphylococcus aureus (MRSA) is often the severe causal agent in this kind of infections. In order to evaluate risk factors for nosocomial infections and nasal MRSA carriage, an incidence study was carried out on patients hospitalized in an orthopaedic surgery department in Boucicaut Hospital (Paris). This study was carried out over a five month period. Data of all the patients who stayed more than two days in the unit were collected in medical and nursing records. Nasal swab specimens were taken at the admission of each patient included in order to screen nasal MRSA carriers. Statistical analysis were performed using Epi Info software version 6.0. A total of 451 patients were included in the study. Nosocomial infections incidence rate was 11.5%. Risk factor significantly associated with nosocomial infection was high wound containation classes III and IV (Altemeier). Incidence rate of MRSA carriage was 3.1%. A previous hospitalization in a general hospital 6 months before an admission at Boucicaut Hospital was the only risk factor identified. According to this, these patients, when they are admitted, are proposed to be preventely isolated awaiting their microbiological results.
医院感染是发病和死亡的重要原因。耐甲氧西林金黄色葡萄球菌（MRSA）通常是这类感染的严重病原体。为了评估医院感染和鼻腔MRSA携带的危险因素，对布西科医院（巴黎）骨科手术科室住院患者进行了一项发病率研究。该研究持续了五个月。收集了在该科室住院超过两天的所有患者的医疗和护理记录数据。对纳入的每位患者入院时采集鼻拭子标本，以筛查鼻腔MRSA携带者。使用Epi Info软件6.0版进行统计分析。共有451名患者纳入研究。医院感染发病率为11.5%。与医院感染显著相关的危险因素是伤口污染程度高的III级和IV级（阿尔特迈尔分类）。MRSA携带发病率为3.1%。唯一确定的危险因素是在布西科医院入院前6个月曾在综合医院住院。据此，这些患者入院时建议进行预防性隔离，等待微生物学检查结果。
