Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany.
Antimicrob Resist Infect Control. 2012 Jan 26;1(1):3. doi: 10.1186/2047-2994-1-3.
By analysing the data of the intensive care unit (ICU) component of the German national nosocomial infection surveillance system (KISS) during the last ten years, we have observed a steady increase in the MRSA rates (proportions) from 2001 to 2005 and only a slight decrease from 2006 to 2010. The objective of this study was to investigate the development of the incidence density of nosocomial MRSA infections because this is the crucial outcome for patients.
Data from 103 ICUs with ongoing participation during the observation period were included. The pooled incidence density of nosocomial MRSA infections decreased significantly from 0.37 per 1000 patient days in 2001 to 0.15 per 1000 patient days in 2010 (RR = 0.40; CI95 0.29-0.55). This decrease was proportional to the significant decrease of all HCAI during the same time period (RR = 0.61; CI95 0.58-0.65).
The results underline the need to concentrate infection control activities on measures to control HCAI in general rather than focusing too much on specific MRSA prevention measures. MRSA rates (proportions) are not a very useful indicator of the situation.
通过分析过去十年德国国家医院感染监测系统（KISS）重症监护病房（ICU）部分的数据，我们观察到耐甲氧西林金黄色葡萄球菌（MRSA）的比率（比例）从 2001 年到 2005 年稳步上升，而从 2006 年到 2010 年仅略有下降。本研究的目的是调查医院获得性 MRSA 感染发病率密度的发展，因为这是患者的关键结局。
纳入了在观察期内持续参与的 103 个 ICU 的数据。2001 年每 1000 个患者日发生医院获得性 MRSA 感染的发病率密度为 0.37，而 2010 年则显著下降至 0.15（RR=0.40；95%CI95%0.29-0.55）。这一下降与同期所有医院获得性感染（HCAI）的显著下降成正比（RR=0.61；95%CI95%0.58-0.65）。
结果强调需要将感染控制活动集中于一般的 HCAI 控制措施，而不是过于关注特定的 MRSA 预防措施。MRSA 比率（比例）不是衡量情况的非常有用的指标。
