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[感染控制专业人员对耐甲氧西林金黄色葡萄球菌定植医护人员处理方式的看法]

[Infection Control Professionals' Views on the Handling of MRSA-Colonised Healthcare Workers].

作者信息

Peters C, Dulon M, Lietz J, Nienhaus A

机构信息

Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (CVcare), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg.

Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Grundlagen der Prävention und Rehabilitation, Hamburg.

出版信息

Gesundheitswesen. 2017 Aug;79(8-09):648-654. doi: 10.1055/s-0042-108578. Epub 2016 Jun 14.

DOI:10.1055/s-0042-108578
PMID:27300093
Abstract

Colonisation with methicillin-resistant (MRSA) is a particular challenge for medical staff and their facilities, with a key role being played by physicians alongside infection control and hospital hygiene professionals. In 2014, infection control and hygiene staff were surveyed on the handling of hospital staff with MRSA colonisation. The questionnaire queried on MRSA management in hospitals and on the cooperation between hygiene staff and hospital physicians and was compared to a survey of physicians' experience with the care of MRSA-positive hospital staff. 124 hospital hygiene professionals participated in the survey. General screenings of staff members were reported mainly for cases of MRSA outbreak. Temporary colonisation is differentiated from permanent colonisation (47%). 2 unsuccessful attempts at decolonisation are normally regarded as an indicator for a permanent colonisation. Generally there was cooperation between hospital physicians and hygiene staff. The responsibility for screening and decolonisation of staff members is shared by both groups with the groups placing emphasis on different focal points. Different approaches for the handling of MRSA-positive staff were reported and recommendations for the work ability vary from merely observing the standard hygiene regulation to refraining from close patient contact or even complete absence from work. MRSA colonisation in hospital staff is being dealt with in different manners. Infection control and hospital hygiene professionals are equally involved in the treatment. Clear regulations would benefit the handling of MRSA in staff members.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)定植对医护人员及其所在医疗机构而言是一项特殊挑战,医生与感染控制及医院卫生专业人员发挥着关键作用。2014年,针对医院工作人员MRSA定植的处理情况,对感染控制及卫生工作人员进行了调查。问卷询问了医院对MRSA的管理以及卫生工作人员与医院医生之间的合作情况,并与一项关于医生护理MRSA阳性医院工作人员经验的调查进行了比较。124名医院卫生专业人员参与了此次调查。工作人员的常规筛查主要是针对MRSA暴发的情况。临时定植与永久定植有所区分(47%)。通常认为两次去定植尝试未成功是永久定植的一个指标。总体而言,医院医生与卫生工作人员之间存在合作。两组共同承担工作人员筛查和去定植的责任,但侧重点不同。报告了处理MRSA阳性工作人员的不同方法,关于工作能力的建议各不相同,从仅遵守标准卫生规定到避免与患者密切接触甚至完全缺勤。医院工作人员的MRSA定植处理方式各异。感染控制和医院卫生专业人员同样参与治疗。明确的规定将有助于处理工作人员中的MRSA问题。

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