Hitomi S, Kubota M, Mori N, Baba S, Yano H, Okuzumi K, Kimura S
Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan.
J Hosp Infect. 2000 Oct;46(2):123-9. doi: 10.1053/jhin.2000.0786.
In September 1996, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) colonization occurred in the neonatal intensive care unit (NICU) of our hospital. After failing to control the outbreak by conventional methods we implemented an intranasal blanket use programme of mupirocin ointment from the beginning of November 1997. In the programme, patients who had been carrying MRSA received intranasal administration of the ointment three times daily for the first three days and consecutively three times weekly, while newly admitted patients and those who had not been colonized were prophylactically medicated three times weekly. This blanket administration was executed for one month. Methicillin-resistant Staphylococcus aureus colonization became undetectable in all but one intubated inpatient who had already been colonized before the start of the programme, and no new acquisitions occurred until the middle of January 1998, seven weeks after the termination of the blanket use programme. The rate of colonized patients in the unit also decreased. During and after the programme, neither an increase in minimum inhibitory concentration for the antibiotic nor apparent adverse reactions in any of the treated patients were observed. We concluded that this procedure is an effective method of controlling an MRSA outbreak in an NICU when the outbreak cannot be managed with conventional measures.
1996年9月，我院新生儿重症监护病房（NICU）发生了耐甲氧西林金黄色葡萄球菌（MRSA）定植暴发。在用常规方法未能控制住暴发后，我们于1997年11月初实施了莫匹罗星软膏鼻腔全覆盖使用方案。在该方案中，携带MRSA的患者在头三天每天接受三次鼻腔内涂抹软膏，之后连续每周三次；而新入院患者和未被定植的患者则每周预防性用药三次。这种全覆盖给药持续了一个月。除了一名在方案开始前就已被定植的插管住院患者外，在所有患者中均未检测到耐甲氧西林金黄色葡萄球菌定植，并且在全覆盖使用方案终止七周后的1998年1月中旬之前没有出现新的感染情况。该病房定植患者的比例也有所下降。在方案实施期间及之后，未观察到抗生素的最低抑菌浓度增加，也未在任何接受治疗的患者中观察到明显的不良反应。我们得出结论，当暴发无法用常规措施控制时，该方法是控制新生儿重症监护病房耐甲氧西林金黄色葡萄球菌暴发的有效方法。
