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[康复护理单元中获得性耐甲氧西林金黄色葡萄球菌的预测因素]

[Predictive factors of acquired methicillin-resistant Staphylococcus aureus in a rehabilitation care unit].

作者信息

Anguelov A, Giraud K, Akpabie A, Chatap G, Vincent J-P

机构信息

Service du Dr Vincent, Hôpital Emile-Roux, 1 Avenue de Verdun, 94450 Limeil Brevannes, France.

出版信息

Med Mal Infect. 2010 Dec;40(12):677-82. doi: 10.1016/j.medmal.2010.03.005. Epub 2010 Nov 2.

Abstract

UNLABELLED

Controlling the diffusion of multiresistant bacteria is a priority in the campaign against nosocomial infections. Geriatric units seem to be reservoirs of methicillin-resistant Staphylococcus aureus (MRSA).

OBJECTIVE

The first objective of this study was to determine if some characteristics identified on admission in a rehabilitation care unit could influence the colonization by the bacterium, and to define the rate of importation and acquired-infections. The second objective was to evaluate the preventive effects of enhanced cleaning with hydro-alcoholic solution, in comparison with our previous study made five years before.

METHOD

One hundred and eighty-eight patients (mean age, 83.75 ± 7.35 years) were included.

RESULTS

The rates of importation and colonization were respectively of 22.4% and 25.5%. The predictive factors of acquisition were dependence, malnutrition, presence of urinary catheter, and chronic wounds. The comparison with data collected five years earlier showed a reduction of colonization rates from 44 to 25%.

COMMENTS

Our study highlights the important role of hand contamination in colonization of the MRSA especially for dependent patients, and shows the importance of hand-hygiene compliance, as well as maintaining autonomy among old patients. The use of hydro-alcoholic solution in association with the reinforcement of hospital hygiene measures led to the decrease of acquired-infection rate.

摘要

未标注

控制多重耐药菌的传播是抗击医院感染行动中的一项优先任务。老年病房似乎是耐甲氧西林金黄色葡萄球菌(MRSA)的储存库。

目的

本研究的首要目的是确定康复护理单元入院时发现的某些特征是否会影响该细菌的定植,并确定输入率和获得性感染率。第二个目的是与我们五年前进行的先前研究相比,评估用含酒精溶液强化清洁的预防效果。

方法

纳入了188例患者(平均年龄83.75±7.35岁)。

结果

输入率和定植率分别为22.4%和25.5%。获得感染的预测因素为依赖、营养不良、存在导尿管和慢性伤口。与五年前收集的数据相比,定植率从44%降至25%。

评论

我们的研究强调了手部污染在MRSA定植中尤其是对依赖患者的重要作用,并表明了手部卫生依从性以及维持老年患者自主性的重要性。含酒精溶液与加强医院卫生措施联合使用导致获得性感染率下降。

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