Department of Infectious Diseases, Catholic University, Rome, Italy.
Clin Microbiol Infect. 2009 Dec;15 Suppl 7:31-8. doi: 10.1111/j.1469-0691.2009.03096.x.
Methicillin-resistant Staphylococcus aureus (MRSA) has been a common nosocomial pathogen since the 1960s, and has become a major problem in hospitals worldwide. Patients and the public are increasingly seeing MRSA and rates of MRSA infections as indicators of the quality of patient care. The control measures aimed at reducing the spread of MRSA among hospitals and communities include the following: education of healthcare workers, with implementation and adherence to hand-washing practices; restriction of antibiotic use; active surveillance cultures (ASCs); contact isolation of MRSA-positive patients; and pre-emptive isolation of high-risk patients. However, despite these interventions, MRSA is still endemic in many hospitals worldwide. In particular, the role of ASCs is still under debate. International guidelines suggest that extensive ASCs should only be used in intensive-care units (ICUs), and routine screening of all hospital admissions is not usually advocated. Local decisions can be made on the basis of types of risk factor of non-ICU patients. Before starting ASCs, laboratories should be prepared for the workload, and the turn-around time for screening tests should be reduced and arrangements made to monitor the effectiveness of this intervention. Most recently, rapid methods for molecular detection of MRSA colonization have been developed. Published studies differ in their settings (ICU, medical wards, surgical wards), choice of patient population, severity of illness, hospital infection control measures, and study design. The existing evidence does not support the wide application of rapid molecular screening for MRSA.
耐甲氧西林金黄色葡萄球菌（MRSA）自 20 世纪 60 年代以来一直是一种常见的医院病原体，已成为全球医院的主要问题。患者和公众越来越多地将 MRSA 和 MRSA 感染率视为患者护理质量的指标。旨在减少医院和社区中 MRSA 传播的控制措施包括：医护人员教育，实施和遵守洗手规范；限制抗生素的使用；主动监测培养（ASCs）；对 MRSA 阳性患者进行接触隔离；对高危患者进行预防性隔离。然而，尽管采取了这些干预措施，MRSA 在世界许多医院仍然普遍存在。特别是，ASCs 的作用仍存在争议。国际指南建议，广泛的 ASCs 仅应在重症监护病房（ICU）中使用，通常不提倡对所有住院患者进行常规筛查。可以根据非 ICU 患者的危险因素类型在当地做出决策。在开始 ASCs 之前，实验室应做好应对工作量的准备，应缩短筛选测试的周转时间，并安排监测该干预措施的效果。最近，已经开发出用于快速检测 MRSA 定植的分子检测方法。已发表的研究在其设置（ICU、内科病房、外科病房）、患者人群选择、疾病严重程度、医院感染控制措施和研究设计方面存在差异。现有证据不支持广泛应用快速分子筛查 MRSA。
