Eveillard Matthieu, Mortier Emmanuel, Lancien Evelyne, Lescure François-Xavier, Schmit Jean-Luc, Barnaud Guilène, Lenfant Nelly, Vinceneux Philippe, Joly-Guillou Marie-Laure
Department of Microbiology and Hygiene, Hôpital Louis-Mourier (AP-HP), Colombes, France.
Am J Infect Control. 2006 Apr;34(3):108-13. doi: 10.1016/j.ajic.2006.01.001.
Methicillin-resistant Staphylococcus aureus (MRSA) has become an increasingly important pathogen responsible for hospital-acquired infections. Our study was to evaluate the efficiency of our selective screening program for methicillin-resistant Staphylococcus aureus (MRSA) carriers at admission to nonintensive care units.
During 6 months, all patients were screened at admission to an internal medicine ward, at which time they were classified as patients at risk of carriage (PRC) and those with no known risk factor. The amplitude of cross transmission was estimated using various indicators during this universal screening period and during the same calendar period of the preceding year (selective screening).
The prevalence of MRSA carriage at admission was 5.5%. Among the 22 carriers identified, only 10 were PRC. Age >80 years was significantly associated with MRSA carriage upon admission (OR, 3.5; P < .01). All estimation indicators of MRSA dissemination amplitude were significantly lower during universal screening (relative risks varied from 2.79 to 26.4 according to indicators), demonstrating the need to broaden our criteria defining PRC.
Adding patients >80 years of age to our PRC definition would increase screening sensitivity (15 carriers identified for 128 patients sampled) and would enable early implementation of barrier precautions for the additional carriers identified.
耐甲氧西林金黄色葡萄球菌（MRSA）已成为医院获得性感染中越来越重要的病原体。我们的研究旨在评估在非重症监护病房入院时对耐甲氧西林金黄色葡萄球菌（MRSA）携带者进行选择性筛查计划的有效性。
在6个月期间，对所有内科病房入院患者进行筛查，此时将他们分为有携带风险的患者（PRC）和无已知风险因素的患者。在这个普遍筛查期间以及上一年的同一日历期间（选择性筛查），使用各种指标估计交叉传播的幅度。
入院时MRSA携带率为5.5%。在确定的22名携带者中，只有10名是PRC。年龄>80岁与入院时MRSA携带显著相关（比值比，3.5；P <.01）。在普遍筛查期间，MRSA传播幅度的所有估计指标均显著较低（根据指标，相对风险从2.79到26.4不等），这表明需要扩大我们定义PRC的标准。
将80岁以上患者纳入我们的PRC定义将提高筛查敏感性（对128名抽样患者确定了15名携带者），并能够对额外确定的携带者尽早实施隔离预防措施。
