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爱荷华州长期护理机构中耐甲氧西林金黄色葡萄球菌或耐万古霉素肠球菌感染居民的政策与实践调查。

Survey of long-term-care facilities in Iowa for policies and practices regarding residents with methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci.

作者信息

Kreman Trisha, Hu Jianfang, Pottinger Jean, Herwaldt Loreen A

机构信息

Department of Epidemiology, University of lowa College of Public Health, Iowa City, IA 52242-1081, USA.

出版信息

Infect Control Hosp Epidemiol. 2005 Oct;26(10):811-5. doi: 10.1086/502498.

Abstract

OBJECTIVES

To identify infection control policies and practices used by long-term-care facilities (LTCFs) in Iowa for residents with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE), and to estimate the prevalence of residents known to have these organisms.

DESIGN

Survey.

SETTING

LTCFs in Iowa from December 2002 through March 2003.

RESULTS

Of the 429 LTCFs in Iowa, 331 (77%) responded to the survey. The estimated prevalence of residents known to have MRSA was 13.4 per 1,000 and that of residents known to have VRE was 2.3 per 1,000. Facilities owned by the government or those with an average of more than 86 occupied beds were more likely to have residents known to have MRSA and VRE (P = .002 and .007, respectively). Of the responding facilities, 7.3% acknowledged that they refused to accept individuals known to have MRSA and 16.9% acknowledged that they refused to accept those known to have VRE. Facilities in large communities (population, > 100,000) were least likely to deny admission to an individual known to have either MRSA or VRE (P = .05). Most facilities reported adhering to the national guidelines, but fewer than half (44.7%) of the respondents had heard of the Iowa Antibiotic Resistance Task Force's guidelines regarding residents with MRSA or VRE.

CONCLUSIONS

Many LTCFs in Iowa care for residents known to have MRSA or VRE, but some refuse to admit these individuals. Infection control personnel and public health officials should work together to educate LTCF staff so that residents receive proper care and resistant organisms do not spread within this setting.

摘要

目的

确定爱荷华州长期护理机构(LTCFs)针对耐甲氧西林金黄色葡萄球菌(MRSA)或耐万古霉素肠球菌(VRE)患者所采用的感染控制政策和措施,并估计已知感染这些病原体的患者患病率。

设计

调查。

地点

2002年12月至2003年3月期间爱荷华州的长期护理机构。

结果

爱荷华州的429家长期护理机构中,331家(77%)回复了调查。已知感染MRSA的患者估计患病率为每1000人中有13.4人,已知感染VRE的患者患病率为每1000人中有2.3人。政府所有的机构或平均床位占用超过86张的机构,其居民感染MRSA和VRE的可能性更高(P值分别为0.002和0.007)。在回复调查的机构中,7.3%承认拒绝接收已知感染MRSA的患者,16.9%承认拒绝接收已知感染VRE的患者。大型社区(人口>100,000)的机构拒绝接收已知感染MRSA或VRE患者的可能性最小(P = 0.05)。大多数机构报告称遵循国家指南,但不到一半(44.7%)的受访者听说过爱荷华州抗生素耐药性特别工作组关于MRSA或VRE患者的指南。

结论

爱荷华州的许多长期护理机构都在照顾已知感染MRSA或VRE的患者,但有些机构拒绝接收这些患者。感染控制人员和公共卫生官员应共同努力,对长期护理机构的工作人员进行教育,以便患者得到妥善护理,耐药病原体不会在该环境中传播。

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