Laboratory of Healthcare Associated Infection, Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London NW95EQ, UK.
Int J Antimicrob Agents. 2011 Mar;37(3):195-201. doi: 10.1016/j.ijantimicag.2010.10.023. Epub 2010 Dec 15.
Meticillin-resistant Staphylococcus aureus (MRSA) infections are of increasing importance to clinicians, public health agencies and governments. Prevention and control strategies must address sources in healthcare settings, the community and livestock. This document presents the conclusions of a European Consensus Conference on the role of screening and decolonisation in the control of MRSA infection. The conference was held in Rome on 5-6 March 2010 and was organised jointly by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC). In an environment where MRSA is endemic, universal or targeted screening of patients to detect colonisation was considered to be an essential pillar of any MRSA control programme, along with the option of decolonising carriers dependent on relative risk of infection, either to self or others, in a specific setting. Staff screening may be useful but is problematic as it needs to distinguish between transient carriage and longer-term colonisation. The consequences of identification of MRSA-positive staff may have important effects on morale and the ability to maintain staffing levels. The role of environmental contamination in MRSA infection is unclear, but screening may be helpful as an audit of hygiene procedures. In all situations, screening procedures and decolonisation carry a significant cost burden, the clinical value of which requires careful evaluation. European initiatives designed to provide further information on the cost/benefit value of particular strategies in the control of infection, including those involving MRSA, are in progress.
耐甲氧西林金黄色葡萄球菌（MRSA）感染对临床医生、公共卫生机构和政府越来越重要。预防和控制策略必须针对医疗机构、社区和牲畜中的来源。本文介绍了 2010 年 3 月 5 日至 6 日在罗马举行的欧洲共识会议关于筛查和去定植在控制 MRSA 感染中的作用的结论。该会议由欧洲临床微生物学和传染病学会（ESCMID）和国际化疗学会（ISC）联合举办。在 MRSA 流行的环境中，对患者进行普遍或有针对性的筛查以检测定植被认为是任何 MRSA 控制计划的重要支柱，同时根据感染的相对风险，在特定环境中对携带者进行去定植的选择取决于自身或他人的感染风险。员工筛查可能有用，但存在问题，因为它需要区分短暂携带和长期定植。确定 MRSA 阳性员工的后果可能对士气和维持人员配备水平产生重要影响。环境污染在 MRSA 感染中的作用尚不清楚，但筛查可能有助于作为卫生程序审核。在所有情况下，筛查程序和去定植都带来了重大的成本负担，其临床价值需要仔细评估。欧洲正在开展旨在提供有关特定感染控制策略（包括涉及 MRSA 的策略）的成本/效益价值的进一步信息的倡议。
