Diekema Daniel J, Edmond Michael B
University of Iowa Healthcare, Iowa City, IA, USA.
Clin Infect Dis. 2007 Apr 15;44(8):1101-7. doi: 10.1086/512820. Epub 2007 Mar 2.
Hospitals in the United States are under increasing pressure to perform active surveillance cultures for detection of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) among newly admitted patients. Results of such cultures can then be used to direct contact precautions to prevent transmission of MRSA and VRE in the health care setting. However, using active surveillance cultures to expand contact precautions is a complicated and resource-intensive intervention that has the potential for several unintended adverse consequences. Therefore, careful forethought and preparation should precede the institution of any active surveillance culture program. We review the following important steps that should be performed when planning any such intervention: preparing the laboratory and reducing the turnaround time for screening tests, monitoring and optimizing the intervention of instituting contact precautions, monitoring and ameliorating the known adverse effects of contact precautions, and measuring important outcomes to evaluate the effectiveness of a program of active surveillance cultures and contact precautions.
美国医院面临着越来越大的压力，需要对新入院患者进行主动监测培养，以检测耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）。这些培养结果随后可用于指导接触预防措施，以防止MRSA和VRE在医疗环境中传播。然而，使用主动监测培养来扩大接触预防措施是一项复杂且资源密集型的干预措施，有可能产生一些意想不到的不良后果。因此，在实施任何主动监测培养计划之前，应进行仔细的预先考虑和准备。我们回顾了在规划任何此类干预措施时应采取的以下重要步骤：准备实验室并缩短筛查测试的周转时间，监测和优化实施接触预防措施的干预措施，监测和改善接触预防措施的已知不良影响，以及衡量重要结果以评估主动监测培养和接触预防措施计划的有效性。
