Panlilio A L, Culver D H, Gaynes R P, Banerjee S, Henderson T S, Tolson J S, Martone W J
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333.
Infect Control Hosp Epidemiol. 1992 Oct;13(10):582-6. doi: 10.1086/646432.
Analyze changes that have occurred among U.S. hospitals over a 17-year period, 1975 through 1991, in the percentage of Staphylococcus aureus resistant to beta-lactam antibiotics and associated with nosocomial infections.
Retrospective review. The percentage of methicillin-resistant S aureus (MRSA) was defined as the number of S aureus isolates resistant to either methicillin, oxacillin, or nafcillin divided by the total number of S aureus isolates for which methicillin, oxacillin, or nafcillin susceptibility test results were reported to the National Nosocomial Infections Surveillance (NNIS) System.
NNIS System hospitals.
Of the 66,132 S aureus isolates that were tested for susceptibility to methicillin, oxacillin, or nafcillin during 1975 through 1991, 6,986 (11%) were resistant to methicillin, oxacillin, or nafcillin. The percentage MRSA among all hospitals rose from 2.4% in 1975 to 29% in 1991, but the rate of increase differed significantly among 3 bed-size categories: < 200 beds, 200 to 499 beds, and > or = 500 beds. In 1991, for hospitals with < 200 beds, 14.9% of S aureus isolates were MRSA; for hospitals with 200 to 499 beds, 20.3% were MRSA; and for hospitals with > or = 500 beds, 38.3% were MRSA. The percentage MRSA in each of the bed-size categories rose above 5% at different times: in 1983, for hospitals with > or = 500 beds; in 1985, for hospitals with 200 to 499 beds; and in 1987, for hospitals with < 200 beds.
This study suggests that hospitals of all sizes are facing the problem of MRSA, the problem appears to be increasing regardless of hospital size, and control measures advocated for MRSA appear to require re-evaluation. Further study of MRSA in hospitals would benefit our understanding of this costly pathogen.
分析1975年至1991年这17年间美国医院中对β-内酰胺类抗生素耐药且与医院感染相关的金黄色葡萄球菌的百分比变化情况。
回顾性研究。耐甲氧西林金黄色葡萄球菌（MRSA）的百分比定义为对甲氧西林、苯唑西林或萘夫西林耐药的金黄色葡萄球菌分离株数量除以向国家医院感染监测（NNIS）系统报告了甲氧西林、苯唑西林或萘夫西林药敏试验结果的金黄色葡萄球菌分离株总数。
NNIS系统医院。
在1975年至1991年期间对甲氧西林、苯唑西林或萘夫西林进行药敏试验的66132株金黄色葡萄球菌分离株中，有6986株（11%）对甲氧西林、苯唑西林或萘夫西林耐药。所有医院中MRSA的百分比从1975年的2.4%上升至1991年的29%，但在三个床位规模类别（床位<200张、200至499张、≥500张）中，上升速率存在显著差异。1991年，床位<200张的医院中，14.9%的金黄色葡萄球菌分离株为MRSA；200至499张床位的医院中，20.3%为MRSA；≥500张床位的医院中，38.3%为MRSA。每个床位规模类别中MRSA的百分比在不同时间升至5%以上：1983年，≥500张床位的医院；1985年，200至499张床位的医院；1987年，<200张床位的医院。
本研究表明，各种规模的医院都面临着MRSA问题，无论医院规模大小，该问题似乎都在加剧，且针对MRSA所倡导的控制措施似乎需要重新评估。对医院中MRSA的进一步研究将有助于我们了解这种代价高昂的病原体。
