Peterson Lance R, Hacek Donna M, Robicsek Ari
Northwestern University, Feinberg School of Medicine, Department of Medicine and Pathology, Evanston, Illinois, USA.
Jt Comm J Qual Patient Saf. 2007 Dec;33(12):732-8. doi: 10.1016/s1553-7250(07)33088-2.
PCR-based testing offers superiority to culture in reduction of unisolated days. The ICU-based surveillance intervention had little impact after one year with surveillance compliance at 67%. However, once compliance improved, surveillance was expanded to the entire hospital and decolonization was implemented, MRSA BSIs were significantly reduced. Our experience parallels that of the European countries and other United States facilities that have implemented aggressive MRSA control measures. All successful programs have included active surveillance testing and barrier precautions. Finally, according to the Centers for Disease Control and Prevention's just-released report on invasive MRSA, since most MRSA infections are associated with health care contact, strategies to prevent and control MRSA among inpatients still may have a positive impact on infection, as demonstrated by our intervention.
基于聚合酶链反应（PCR）的检测在减少未检出天数方面比培养法更具优势。以重症监护病房（ICU）为基础的监测干预在实施一年后效果甚微，监测依从率为67%。然而，一旦依从性提高，监测范围扩大到整个医院并实施去定植措施后，耐甲氧西林金黄色葡萄球菌（MRSA）血流感染（BSIs）显著减少。我们的经验与欧洲国家和美国其他实施积极MRSA控制措施的机构相似。所有成功的项目都包括主动监测检测和屏障预防措施。最后，根据美国疾病控制与预防中心刚刚发布的关于侵袭性MRSA的报告，由于大多数MRSA感染与医疗接触有关，正如我们的干预所表明的，在住院患者中预防和控制MRSA的策略仍可能对感染产生积极影响。
