Robert J, Renard L, Grenet K, Galerne E, Dal Farra A, Aussant M, Jarlier V
Service de Bactériologie-Hygiène, Equipe Opérationnelle d'Hygiène, Hôpital de la Pitié-Salpêtrière et Faculté de Médecine Pierre et Marie Curie, Paris, France.
J Hosp Infect. 2006 Feb;62(2):163-5. doi: 10.1016/j.jhin.2005.07.003. Epub 2005 Oct 27.
Isolation precautions are advocated in most countries for patients harbouring multi-drug-resistant organisms. We evaluated the impact of a targeted information flyer on the implementation of isolation precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA). A flyer providing a quick reference to the steps to be implemented following detection of MRSA was sent systematically by the microbiologists with all results displaying MRSA. Infection control staff compared isolation precautions in two three-month periods: the first (control) period before implementation of the flyer and the second (intervention) period after implementation of the flyer. Compared with the control period, compliance with isolation precautions increased significantly in the intervention period. In intensive care units, there was a sign posted on the door for 31 of 38 (82%) patients in the control period, and 33 out of 34 (97%) in the intervention period (P=0.06). Use of gowns increased from 82% to 100% (P=0.01), use of dedicated materials increased from 84% to 100% (P=0.03), availability of alcohol hand rub increased from 82% to 94% (P=0.10), and the proportion of MRSA patients in private rooms increased from 71% to 91% of the cases (P=0.07). In conclusion, compliance with isolation precautions increased after attaching a flyer to all MRSA-positive bacteriological results.
大多数国家都提倡对携带多重耐药菌的患者采取隔离预防措施。我们评估了一份针对性信息传单对耐甲氧西林金黄色葡萄球菌(MRSA)患者隔离预防措施实施情况的影响。微生物学家会将一份提供检测到MRSA后应采取步骤快速参考的传单,与所有显示MRSA的结果一起系统地发送出去。感染控制人员比较了两个为期三个月的时间段内的隔离预防措施:第一个(对照)时间段是在传单实施之前,第二个(干预)时间段是在传单实施之后。与对照期相比,干预期内隔离预防措施的依从性显著提高。在重症监护病房,对照期38名患者中有31名(82%)的门上张贴了标识,干预期34名患者中有33名(97%)(P=0.06)。隔离衣的使用从82%增加到100%(P=0.01),专用材料的使用从84%增加到100%(P=0.03),酒精擦手液的配备从82%增加到94%(P=0.10),MRSA患者住在单人病房的比例从71%增加到91%(P=0.07)。总之,在所有MRSA阳性细菌学结果上附上传单后,隔离预防措施的依从性有所提高。