Tampa General Hospital, Tampa, FL 33606, USA.
Am J Infect Control. 2013 Jul;41(7):629-33. doi: 10.1016/j.ajic.2012.09.003. Epub 2013 Jan 16.
Surgical site infections (SSIs) associated with methicillin-resistant Staphylococcus aureus (MRSA) are a major complication of surgery. This study is part of a large infection control quality improvement effort to eliminate MRSA SSIs.
This is an Institutional Review Board-approved, case-control study examining MRSA SSI rates before and after implementation of a facility-wide MRSA SSI prevention protocol in 2007. The protocol involved a 5-day course of intranasal mupirocin and nonrinse 2% chlorhexidine gluconate cloths.
In 2006, a total of 39 MRSA SSIs occurred after 9,976 procedures in patients who underwent orthopedic, vascular, cardiac, or neurosurgical procedures (rate = 0.39 per 100 procedures). The highest incidence occurred after cardiac surgery (rate = 1.24/100 procedures), and the lowest occurred after orthopedic surgery (rate = 0.28/100 procedures). In 2007, the MRSA SSI rate decreased to 20 of 9,818 procedures (rate = 0.20/100 procedures) in the 4 categories (P = .016; odds ratio, 1.92). In 2008, the MRSA SSI rate dropped again to 13 of 10,068 procedures (rate = 0.13/100 procedures) in the 4 categories (P = .0003; odds ratio, 3.04).
A 5-day course of intranasal mupirocin and nonrinse 2% chlorhexidine gluconate cloths may be beneficial in preventing MRSA SSIs in the non-general surgery population.
耐甲氧西林金黄色葡萄球菌（MRSA）相关的手术部位感染（SSI）是手术的主要并发症。本研究是一项大规模感染控制质量改进工作的一部分，旨在消除 MRSA SSI。
这是一项经机构审查委员会批准的病例对照研究，检查了 2007 年在实施全机构 MRSA SSI 预防方案前后的 MRSA SSI 发生率。该方案包括 5 天疗程的鼻腔莫匹罗星和非冲洗 2%葡萄糖酸氯己定布。
2006 年，在接受骨科、血管、心脏或神经外科手术的 9976 例患者中，共发生 39 例 MRSA SSI（发生率为每 100 例手术 0.39 例）。发生率最高的是心脏手术后（发生率为 1.24/100 例手术），最低的是骨科手术后（发生率为 0.28/100 例手术）。2007 年，4 类手术中 MRSA SSI 发生率降至 9818 例中的 20 例（发生率为每 100 例手术 0.20 例）（P=0.016；比值比，1.92）。2008 年，4 类手术中 MRSA SSI 发生率再次降至 10068 例中的 13 例（发生率为每 100 例手术 0.13 例）（P=0.0003；比值比，3.04）。
鼻腔莫匹罗星和非冲洗 2%葡萄糖酸氯己定布 5 天疗程可能有益于预防非普外科人群中的 MRSA SSI。
