长期急性护理机构中耐甲氧西林金黄色葡萄球菌和鲍曼不动杆菌的患病率。
Prevalence of methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii in a long-term acute care facility.
作者信息
Furuno Jon P, Hebden Joan N, Standiford Harold C, Perencevich Eli N, Miller Ram R, Moore Anita C, Strauss Sandra M, Harris Anthony D
机构信息
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
出版信息
Am J Infect Control. 2008 Sep;36(7):468-71. doi: 10.1016/j.ajic.2008.01.003.
BACKGROUND
Patients in long-term acute care (LTAC) facilities often have many known risk factors for acquisition of antibiotic-resistant bacteria. However, the prevalence of resistance in these facilities has not been well described.
METHODS
We performed a single-day, point-prevalence study of a 180-bed, university-affiliated LTAC facility in Baltimore to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii in the anterior nares, perirectal area, sputum, and wounds.
RESULTS
Among the 147 patients evaluated, we found a high prevalence of colonization by both MRSA (28%) and A baumannii (30%). Of the A baumannii isolates, 90% were susceptible to imipenem and 92% were susceptible to ampicillin-sulbactam. No isolates were resistant to both imipenem and ampicillin-sulbactam.
CONCLUSION
The high prevalence of resistance found in this study supports the need for increased surveillance of patients in the LTAC environment. The fact that these patients are often frequently transferred to tertiary care facilities also supports the need for coordination and collaboration among facilities within the same health care system and the broader geographic area.
背景
长期急性护理（LTAC）机构中的患者通常有许多已知的获得性抗生素耐药菌风险因素。然而，这些机构中的耐药率尚未得到充分描述。
方法
我们对巴尔的摩一家拥有180张床位、与大学相关的LTAC机构进行了单日现患率研究，以评估耐甲氧西林金黄色葡萄球菌（MRSA）和鲍曼不动杆菌在前鼻孔、直肠周围区域、痰液和伤口中的流行情况。
结果
在评估的147例患者中，我们发现MRSA（28%）和鲍曼不动杆菌（30%）的定植率都很高。在鲍曼不动杆菌分离株中，90%对亚胺培南敏感，92%对氨苄西林-舒巴坦敏感。没有分离株对亚胺培南和氨苄西林-舒巴坦都耐药。
结论
本研究中发现的高耐药率支持了加强对LTAC环境中患者监测的必要性。这些患者经常频繁转至三级护理机构这一事实也支持了同一医疗系统内及更广泛地理区域内各机构之间进行协调与合作的必要性。
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