Elstrøm Petter, Iversen Bjørn, Aavitsland Preben
Divisjon for smittevern, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo.
Tidsskr Nor Laegeforen. 2008 Jan 31;128(3):291-3.
Patients with increased risk of colonisation with Methicillin-resistant Staphylococcus aureus (MRSA) are screened before admission to hospitals in Norway. Denmark and the Netherlands have introduced routine screening of all children adopted from abroad before hospital admission. The present study aims at identifying whether children adopted to Norway had a higher risk of being MRSA-positive than other children of the same age.
Incidence rates and relative risks for MRSA-infections or colonisation were calculated for children adopted from abroad and for other children. Data from Statistics Norway and the Norwegian Surveillance System for Communicable Diseases (MSIS) were used.
The incidence rate for confirmed MRSA-infection in children < 3 years of age adopted from abroad was 1.1 per 1,000 person year, and that for other children was 0.034 per 1,000 person year in the period 1995-2005. In this period, adopted children had 33 times increased risk of being notified with MRSA-infection. In 2005, the incidence rate for detected colonisation with MRSA was 3.7/1,000 person year for adopted children and 0.053/1,000 person year for other children; i.e. in this year the risk of being found colonised with MRSA was 70 times higher for children adopted from abroad than for others.
Norwegian hospitals should introduce screening for MRSA at hospital admission as a routine for children adopted from abroad during the last 12 months. The National Institute of Public Health should continue to survey the incidence of MRSA among groups in the population and prospectively change the recommendations for MRSA-screening according to new knowledge.
在挪威,耐甲氧西林金黄色葡萄球菌(MRSA)定植风险增加的患者在入院前会接受筛查。丹麦和荷兰已对所有国外收养儿童在入院前进行常规筛查。本研究旨在确定收养到挪威的儿童MRSA呈阳性的风险是否高于其他同龄儿童。
计算国外收养儿童和其他儿童MRSA感染或定植的发病率和相对风险。使用了挪威统计局和挪威传染病监测系统(MSIS)的数据。
1995年至2005年期间,国外收养的3岁以下儿童确诊MRSA感染的发病率为每1000人年1.1例,其他儿童为每1000人年0.034例。在此期间,收养儿童被通报感染MRSA的风险增加了33倍。2005年,收养儿童检测到MRSA定植的发病率为每1000人年3.7例,其他儿童为每1000人年0.053例;即,在这一年,国外收养儿童被发现感染MRSA的风险比其他儿童高70倍。
挪威医院应在入院时对过去12个月内从国外收养的儿童进行MRSA常规筛查。国家公共卫生研究所应继续调查人群中各群体MRSA的发病率,并根据新知识前瞻性地改变MRSA筛查建议。