Hassan K, Paturi A, Hughes C, Giles S
Rotherham District General Hospital Rotherham, Yorkshire, 5 Weston View, Crookes, Sheffield S10 5BZ.
Surgeon. 2008 Aug;6(4):201-3. doi: 10.1016/s1479-666x(08)80027-3.
The aim of this study was to assess the true incidence and prevalence of MRSA colonisation and infection in the elective and trauma orthopaedic population in Rotherham District General Hospital.
This prospective study non-selectively screened 690 consecutive trauma and elective orthopaedic patients over three months in 2005.
Of these, 27 were positive for either colonisation or wound infection with MRSA. Of those, 13 were previously known to have been colonised with MRSA and the 14 others were unexpectedly either colonised or subsequently developed wound infections. The new cases would not have been identified using any current selective screening protocol, as they did not fall into a high-risk category. Many were young, had no co-morbidities and no contact with hospitals in the past. Our study seems to indicate that selective screening will miss a significant number of cases.
We conclude that MRSA screening for all orthopaedic patients is needed when admitted to hospital, as colonisation is no longer confined to what has been previously identified as high-risk groups. The consequences of a subsequent MRSA infection have significant implications, socially, financially and clinically.
本研究的目的是评估罗瑟勒姆区综合医院择期和创伤骨科患者中耐甲氧西林金黄色葡萄球菌（MRSA）定植和感染的实际发病率及患病率。
这项前瞻性研究在2005年的三个月内对690例连续的创伤和择期骨科患者进行了非选择性筛查。
其中，27例患者MRSA定植或伤口感染呈阳性。其中，13例之前已知已被MRSA定植，另外14例则意外地出现了定植或随后发生了伤口感染。使用任何当前的选择性筛查方案都无法识别这些新病例，因为他们不属于高危类别。许多患者很年轻，没有合并症，过去也没有与医院接触过。我们的研究似乎表明，选择性筛查会遗漏大量病例。
我们得出结论，所有骨科患者入院时都需要进行MRSA筛查，因为定植不再局限于先前确定的高危人群。随后发生MRSA感染的后果在社会、经济和临床方面都具有重大影响。
