Emaneini Mohammad, Jabalameli Fereshteh, Rahdar Hosseinali, Leeuwen Willem B van, Beigverdi Reza
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Innovative Molecular Diagnostics, Faculty of Science & Technology, University of Applied Sciences. Leiden. Netherlands.
Rev Soc Bras Med Trop. 2017 Sep-Oct;50(5):590-597. doi: 10.1590/0037-8682-0534-2016.
Globally, methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of healthcare-associated infections. Healthcare workers (HCWs), patients and the environment may act as reservoirs for the spread of MRSA to patients and other HCWs. Screening and eradication of MRSA colonization is an effective method of reducing the MRSA infection rate. There are limited data on the prevalence of MRSA among Iranian HCWs. We performed a systematic search by using different electronic databases including Medline (via PubMed), Embase, Web of Science, and Iranian Databases (from January 2000 to July 2016). Meta-analysis was performed using the Comprehensive Meta-Analysis (Biostat V2.2) software. The meta-analyses showed that the prevalence of S. aureus and MRSA among HCWs were 22.7% [95% confidence interval (CI): 19.3-26.6] and 32.8% (95% CI: 26.0-40.4) respectively. The high rate of nasal MRSA carriage among Iranian HCWs has been attributed to poor compliance to hand hygiene, injudicious use of antibiotics, and ineffective infection control and prevention measures. The rational use of antibiotics plus strict infection control are the main pillars for controlling multidrug resistant microorganisms such as MRSA in the hospital setting. These measurements should be applied nationally.
在全球范围内，耐甲氧西林金黄色葡萄球菌（MRSA）仍然是医疗保健相关感染的主要原因。医护人员、患者和环境可能成为MRSA传播给患者和其他医护人员的储存宿主。筛查和根除MRSA定植是降低MRSA感染率的有效方法。关于伊朗医护人员中MRSA流行情况的数据有限。我们通过使用不同的电子数据库进行了系统检索，包括Medline（通过PubMed）、Embase、科学网和伊朗数据库（从2000年1月至2016年7月）。使用综合荟萃分析（Biostat V2.2）软件进行荟萃分析。荟萃分析表明，医护人员中金黄色葡萄球菌和MRSA的流行率分别为22.7%[95%置信区间（CI）：19.3 - 26.6]和32.8%（95%CI：26.0 - 40.4）。伊朗医护人员鼻腔MRSA携带率高归因于手部卫生依从性差、抗生素使用不当以及感染控制和预防措施无效。合理使用抗生素加上严格的感染控制是医院环境中控制MRSA等多重耐药微生物的主要支柱。这些措施应在全国范围内实施。
