耐甲氧西林金黄色葡萄球菌在外科重症监护病房的筛查和清除：值得吗？

Methicillin-resistant staphylococcus aureus screening and eradication in the surgical intensive care unit: Is it worth it?

机构信息

Department of Surgery, St Elizabeth Health Center, Youngstown, OH 44504, USA.

出版信息

Am J Surg. 2010 Dec;200(6):827-30; discussion 830-1. doi: 10.1016/j.amjsurg.2010.08.003.

DOI:10.1016/j.amjsurg.2010.08.003

PMID:21146028

Abstract

BACKGROUND

The problem of intensive care unit methicillin-resistant Staphylococcus aureus (MRSA) infections has led to routine surveillance and eradication strategies.

METHODS

Our surgical intensive care unit (SICU) admissions receive MRSA nares cultures and if positive are isolated followed by eradication treatment. This strategy was retrospectively reviewed.

RESULTS

Our nares-positive culture rate was 21% (30/145), and the sputum positive (sputum+) rate was 18% (26/145). Positive nares culture (Nares+) was eradicated in 63%. The rate of sputum+ in Nares+ patients was 36% (9/25). The rate of sputum+ in Nares- was 10% (12/115; P = .003). The sputum+ SICU length of stay (LOS) (18 ± 12 days in 23 S+ patients) is longer than in sputum- (10 ± 9 days in 69 S-patients, P = .0002).

CONCLUSIONS

This SICU has high rates of both nares and sputum MRSA cultures. Our data suggest eradicating nares colonization may prevent pneumonia and might decrease SICU LOS.

摘要

背景

重症监护病房耐甲氧西林金黄色葡萄球菌（MRSA）感染问题导致了常规监测和根除策略的出现。

方法

我们的外科重症监护病房（SICU）患者接受 MRSA 鼻腔培养，如果呈阳性，则进行隔离和根除治疗。本研究对该策略进行了回顾性分析。

结果

我们的鼻腔阳性培养率为 21%（30/145），痰阳性（痰+）率为 18%（26/145）。鼻腔阳性培养物（Nares+）的根除率为 63%。Nares+患者中痰阳性的比例为 36%（9/25）。Nares-患者的痰阳性率为 10%（12/115；P =.003）。痰阳性的 SICU 住院时间（LOS）（23 例 S+患者中为 18 ± 12 天）长于痰阴性患者（69 例 S-患者中为 10 ± 9 天，P =.0002）。