Furuno Jon P, Harris Anthony D, Wright Marc-Oliver, Hartley David M, McGregor Jessina C, Gaff Holly D, Hebden Joan N, Standiford Harold C, Perencevich Eli N
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Infect Control Hosp Epidemiol. 2007 Jun;28(6):666-70. doi: 10.1086/518348. Epub 2007 May 14.
To quantify the value of performing active surveillance cultures for detection of methicillin-resistant Staphylococcus aureus (MRSA) on intensive care unit (ICU) discharge.
Prospective cohort study.
Medical ICU (MICU) and surgical ICU (SICU) of a tertiary care hospital.
We analyzed data on adult patients who were admitted to the MICU or SICU between January 17, 2001, and December 31, 2004. All participants had a length of ICU stay of at least 48 hours and had surveillance cultures of anterior nares specimens performed on ICU admission and discharge. Patients who had MRSA-positive clinical cultures in the ICU were excluded.
Of 2,918 eligible patients, 178 (6%) were colonized with MRSA on ICU admission, and 65 (2%) acquired MRSA in the ICU and were identified by results of discharge surveillance cultures. Patients with MRSA colonization confirmed by results of discharge cultures spent 853 days in non-ICU wards after ICU discharge, which represented 27% of the total number of MRSA colonization-days during hospitalization in non-ICU wards for patients discharged from the ICU.
Surveillance cultures of nares specimens collected at ICU discharge identified a large percentage of MRSA-colonized patients who would not have been identified on the basis of results of clinical cultures or admission surveillance cultures alone. Furthermore, these patients were responsible for a large percentage of the total number of MRSA colonization-days during hospitalization in non-ICU wards for patients discharged from the ICU.
量化在重症监护病房（ICU）出院时进行主动监测培养以检测耐甲氧西林金黄色葡萄球菌（MRSA）的价值。
前瞻性队列研究。
一家三级护理医院的内科重症监护病房（MICU）和外科重症监护病房（SICU）。
我们分析了2001年1月17日至2004年12月31日期间入住MICU或SICU的成年患者的数据。所有参与者在ICU的住院时间至少为48小时，且在ICU入院和出院时均对鼻前庭标本进行了监测培养。排除在ICU临床培养结果为MRSA阳性的患者。
在2918名符合条件的患者中，178名（6%）在ICU入院时被MRSA定植，6名（2%）在ICU获得MRSA并通过出院监测培养结果得以确认。出院培养结果证实为MRSA定植的患者在ICU出院后在非ICU病房度过了853天，占从ICU出院患者在非ICU病房住院期间MRSA定植总天数的27%。
在ICU出院时采集的鼻前庭标本监测培养发现了很大比例的MRSA定植患者，这些患者仅凭临床培养结果或入院监测培养结果无法被识别。此外，这些患者占从ICU出院患者在非ICU病房住院期间MRSA定植总天数的很大比例。
