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苏格兰增强型金黄色葡萄球菌菌血症监测项目:成人数据的前 18 个月。

The Scottish enhanced Staphylococcus aureus bacteraemia surveillance programme: the first 18 months of data in adults.

机构信息

Health Protection Scotland, NHS National Services Scotland, Glasgow, UK.

NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK.

出版信息

J Hosp Infect. 2017 Oct;97(2):133-139. doi: 10.1016/j.jhin.2017.06.008. Epub 2017 Jun 8.

Abstract

BACKGROUND

Staphylococcus aureus bacteraemia (SAB) is the second most common source of positive blood cultures, after Escherichia coli, reported within NHS Scotland. Laboratory surveillance has been mandatory in Scotland for SAB since 2001.

AIM

To gain an understanding of the epidemiology of SAB cases and associated risk factors for healthcare and true community onset. Identification of these factors and the patient populations at greatest risk enables the development of focused improvement plans.

METHODS

All NHS boards within NHS Scotland take part in the mandatory enhanced surveillance, with data collected by trained data collectors using nationally agreed definitions.

FINDINGS

Between 1 October 2014 and 31 March 2016, 2256 episodes of SAB in adults were identified. The blood cultures were taken in 58 hospitals and across all 15 Scottish health boards. The data demonstrated that approximately one-third of all SAB cases are true community cases. Vascular access devices continue to be the most reported entry point (25.7%) in individuals who receive health care, whereas skin and soft tissue risk factors are present in all origins. A significant risk factor unique to community cases is illicit drug injection.

CONCLUSION

Improvement plans for reduction of SAB should be targeted more widely than hospital care settings alone.

摘要

背景

金黄色葡萄球菌菌血症(SAB)是 NHS 苏格兰报告的阳性血培养第二大常见来源,仅次于大肠杆菌。自 2001 年以来,苏格兰对 SAB 的实验室监测一直是强制性的。

目的

了解 SAB 病例的流行病学情况以及与医疗保健和真正社区发病相关的危险因素。确定这些因素和风险最高的患者人群,使我们能够制定有针对性的改进计划。

方法

NHS 苏格兰的所有 NHS 委员会都参与了强制性的强化监测,由经过培训的数据收集员使用国家商定的定义进行数据收集。

结果

2014 年 10 月 1 日至 2016 年 3 月 31 日,共发现 2256 例成人 SAB 病例。这些血培养样本取自 58 家医院和苏格兰 15 家卫生委员会。数据表明,大约三分之一的 SAB 病例是真正的社区病例。血管内接入装置仍然是接受医疗保健人群中报告最多的进入点(25.7%),而皮肤和软组织危险因素存在于所有来源。社区病例特有的一个重要危险因素是非法药物注射。

结论

减少 SAB 的改进计划不应仅针对医院护理环境,而应更广泛地针对。

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