Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland.
Surgeon. 2012 Apr;10(2):75-9. doi: 10.1016/j.surge.2011.01.008. Epub 2011 Mar 25.
MRSA is a major economic and health issue internationally and as such is of particular importance in the appropriate management of orthopaedic patients. Bone, joint and implant infection can lead to unfavourable outcomes with a long protracted in hospital stay inevitable. The cost for the patient, the hospital and society are substantial.
This study was a review of a prospectively maintained database from our unit over three time points from 2005 to 2007. At each time point a new infection control measure was implemented in an effort to reduce MRSA infections. Total rates of MRSA infection and colonisation in all orthopaedic patients were recorded, before and after separation of trauma and elective services, and after the introduction of a screening pre assessment clinic.
12259 orthopaedic patients were reviewed over the three years. The mean age of MRSA infected patients was 71. A higher proportion of female patients were infected than male patients. The mean length of stay for infected patients was 23.4 days. The rate of infection dropped from 0.49% in 2005 to 0.24%in 2007. After the introduction of these measures there was a substantial reduction in organ space and deep tissue infections.
The separation of emergency and elective orthopaedic services coupled with effective pre-operative screening has resulted in a significant reduction in MRSA infection despite an ever increasing prevalance.
MRSA 是一个国际性的重大经济和健康问题，因此在骨科患者的合理管理中尤为重要。骨、关节和植入物感染可导致不良后果，住院时间必然延长。患者、医院和社会的成本都很高。
本研究回顾了我们单位在 2005 年至 2007 年三个时间点的前瞻性维护数据库。在每个时间点，我们实施了新的感染控制措施，以降低 MRSA 感染率。记录了所有骨科患者的 MRSA 感染和定植总率，包括在创伤和择期服务分离前后，以及引入筛查前评估诊所之后。
三年间共回顾了 12259 例骨科患者。MRSA 感染患者的平均年龄为 71 岁。女性患者感染的比例高于男性患者。感染患者的平均住院时间为 23.4 天。感染率从 2005 年的 0.49%降至 2007 年的 0.24%。采取这些措施后，器官间隙和深部组织感染显著减少。
尽管 MRSA 的流行率不断上升，但将急诊和择期骨科服务分开，并结合有效的术前筛查，已显著降低了 MRSA 感染率。
