与退伍军人事务部预防措施相关的耐甲氧西林金黄色葡萄球菌医疗保健相关感染减少八年。
Eight years of decreased methicillin-resistant Staphylococcus aureus health care-associated infections associated with a Veterans Affairs prevention initiative.
作者信息
Evans Martin E, Kralovic Stephen M, Simbartl Loretta A, Jain Rajiv, Roselle Gary A
机构信息
MRSA/MDRO Prevention Office, National Infectious Diseases Service, Patient Care Services, Veterans Health Administration, Washington, DC; Lexington Veterans Affairs Medical Center, Lexington, KY; Department of Internal Medicine, Division of Infectious Diseases, University of Kentucky School of Medicine, Lexington, KY.
National Infectious Diseases Service, Patient Care Services, Veterans Health Administration, Washington, DC; Cincinnati Veterans Affairs Medical Center, Cincinnati, OH; Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH.
出版信息
Am J Infect Control. 2017 Jan 1;45(1):13-16. doi: 10.1016/j.ajic.2016.08.010.
BACKGROUND
Declines in methicillin-resistant Staphylococcus aureus (MRSA) health care associated infections (HAIs) were previously reported in Veterans Affairs acute care (2012), spinal cord injury (SCIU) (2011), and long-term-care facilities (LTCFs) (2012). Here we report continuing declines in infection rates in these settings through September 2015.
METHODS
Monthly data entered into a national database from 127 acute care facilities, 22 SCIUs, and 133 LTCFs were evaluated for trends using negative binomial regression.
RESULTS
There were 23,153,240 intensive care unit (ICU) and non-ICU, and 1,794,234 SCIU patient-days from October 2007-September 2015, and 22,262,605 LTCF resident-days from July 2009-September 2015. Admission nasal swabbing remained >92% in all 3 venues. Admission prevalence changed from 13.2%-13.5% in acute care, from 35.1%-32.0% in SCIUs, and from 23.1%-25.0% in LTCFs during the analysis periods. Monthly HAI rates fell 87.0% in ICUs, 80.1% in non-ICUs, 80.9% in SCIUs, and 49.4% in LTCFs (all P values < .0001 for trend). During September 2015, there were 2 MRSA HAIs reported in ICUs, 20 (with 3 in SCIUs) in non-ICUs, and 31 in LTCFs nationwide.
CONCLUSIONS
MRSA HAI rates declined significantly in acute care, SCIUs, and LTCFs over 8 years of the Veterans Affairs MRSA Prevention Initiative.
背景
先前有报道称，退伍军人事务部的急性护理机构（2012年）、脊髓损伤机构（SCIU，2011年）和长期护理机构（LTCF，2012年）中耐甲氧西林金黄色葡萄球菌（MRSA）的医疗保健相关感染（HAI）有所下降。在此，我们报告这些机构截至2015年9月感染率持续下降的情况。
方法
使用负二项回归对来自127家急性护理机构、22个SCIU和133个LTCF输入国家数据库的月度数据进行趋势评估。
结果
2007年10月至2015年9月期间，重症监护病房（ICU）和非ICU有23,153,240个患者日，SCIU有1,794,234个患者日，2009年7月至2015年9月期间，LTCF有22,262,605个居民日。在所有3个场所，入院时鼻拭子检测率均保持>92%。在分析期间，急性护理机构的入院患病率从13.2% - 13.5%，SCIU从35.1% - 32.0%，LTCF从23.1% - 25.0%。每月HAI发生率在ICU下降了87.0%，非ICU下降了80.1%，SCIU下降了80.9%，LTCF下降了49.4%（所有趋势的P值均<0.0001）。2015年9月，全国范围内ICU报告了2例MRSA HAI，非ICU报告了20例（其中SCIU有3例），LTCF报告了31例。
结论
在退伍军人事务部MRSA预防倡议的8年中，急性护理机构、SCIU和LTCF的MRSA HAI发生率显著下降。
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