Whyte D, Monahan R, Boyle L, Slevin B, FitzGerald R, Barron D, De Freitas J, Kelleher K
Department of Public Health, Health Service Executive Mid-Western Area, Ireland.
Department of Medical Microbiology, Mid-Western Regional Hospital, Limerick, Ireland.
Euro Surveill. 2005 May;10(5):9-10. doi: 10.2807/esm.10.05.00538-en.
Concerns about healthcare-associated infections and the global crisis in antimicrobial resistance has combined to accentuate the fears around so-called "superbugs". In Ireland there is no single agreed indicator regarded as a true measure of the level of methicillin resistant Staphylococcus aureus (MRSA) in hospitals. The objective of this study was to compare two crude measures of MRSA - the percentage of bacteraemia caused by MRSA and the incidence rate (per 1000 bed days used) of MRSA bacteraemia in six acute hospitals. We examined all blood cultures positive for S. aureus (methicillin sensitive and resistant) from 2002 to 2004 in the Health Service Executive (HSE) Mid-Western Area of Ireland. Hospital In-Patient Enquiry (HIPE) data was used to determine monthly in-patient bed days used. Of 245 patient episodes of bacteraemia, 119 were MRSA. The trends in the percentage of isolates that were MRSA and the incidence rate calculated were compared. The incidence rate appears to be a more reliable and robust indicator of MRSA in hospitals than the percentage. Despite many difficulties in interpreting indicators of MRSA they should not preclude the regular publication of data at least at regional level in Ireland.
对医疗保健相关感染的担忧以及全球抗微生物药物耐药性危机，共同加剧了人们对所谓“超级细菌”的恐惧。在爱尔兰，没有一个被广泛认可的单一指标可被视为衡量医院中耐甲氧西林金黄色葡萄球菌（MRSA）水平的真正标准。本研究的目的是比较两种MRSA的粗略衡量指标——MRSA引起的菌血症百分比以及六家急症医院中MRSA菌血症的发病率（每1000个使用的床日）。我们检查了2002年至2004年爱尔兰卫生服务局（HSE）中西部地区所有金黄色葡萄球菌（甲氧西林敏感和耐药）血培养阳性结果。利用医院住院患者查询（HIPE）数据来确定每月使用的住院床日。在245例菌血症患者中，119例为MRSA。比较了MRSA分离株百分比和计算出的发病率的趋势。发病率似乎比百分比更能可靠且有力地反映医院中MRSA的情况。尽管在解释MRSA指标方面存在诸多困难，但至少在爱尔兰地区层面，不应妨碍定期公布相关数据。
