Department of Communicable Disease Control and Prevention, Stockholm County Council, Stockholm, Sweden.
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Eur J Clin Microbiol Infect Dis. 2019 Dec;38(12):2221-2228. doi: 10.1007/s10096-019-03664-2. Epub 2019 Aug 3.
To review the epidemiology and measures to control meticillin-resistant Staphylococcus aureus, MRSA, in Stockholm between 2000 and 2016 from the perspective of the Department of Communicable Disease Control and Prevention, Stockholm County Council, Sweden. Age, sex, and place of acquisition of their MRSA on all patients reported to the department were reviewed. Measures for control included surveillance through mandatory reporting of cases, screening patients with risk factors for MRSA, strict adherence to basic nursing hygienic principles, isolation of MRSA positive patients in single rooms in dedicated MRSA wards, and cohorting of staff. An MRSA team was created at the Department of Infectious Diseases, Karolinska University Hospital, for follow-up of all cases. Several administrative meetings and cooperative groups were formed that are still in function. From 2000 to 2016, there were 7373 MRSA cases reported. Healthcare-associated MRSA, HA-MRSA, was successfully controlled, and from 2006 onwards, very limited HA-MRSA transmission or outbreaks occurred. However, incidence increased overall, from 9.5 per 100,000 in 2000 to 37.3 per 100,000 in 2016, due to increase of MRSA acquired abroad and of MRSA acquired in the Swedish community. Surveillance and control measures have been successful in containing HA-MRSA in Stockholm, Sweden, but incidence has increased substantially due to imported cases and spread in the Swedish community. The strategy may be termed "search-and-contain" since screening, infection control, follow-up, and advice on personal hygiene were cornerstones of control, whereas eradication of carriage was not.
从瑞典斯德哥尔摩郡传染病控制和预防部的角度，回顾 2000 年至 2016 年间耐甲氧西林金黄色葡萄球菌（MRSA）在该地区的流行病学和控制措施。回顾了报告给该部门的所有患者的年龄、性别和 MRSA 获得地点。控制措施包括通过强制性报告病例进行监测、对有 MRSA 危险因素的患者进行筛查、严格遵守基本护理卫生原则、将 MRSA 阳性患者隔离在专门的 MRSA 病房的单人房间中，以及对员工进行分组。传染病科在卡罗林斯卡大学医院成立了一个 MRSA 小组，负责跟踪所有病例。成立了几个行政会议和合作小组，这些小组至今仍在运作。2000 年至 2016 年，共报告了 7373 例 MRSA 病例。成功控制了与医疗保健相关的 MRSA（HA-MRSA），自 2006 年以来，HA-MRSA 的传播或爆发非常有限。然而，由于国外获得的 MRSA 和瑞典社区获得的 MRSA 数量增加，总发病率上升，从 2000 年的每 10 万人 9.5 例上升到 2016 年的每 10 万人 37.3 例。监测和控制措施已成功遏制了瑞典斯德哥尔摩的 HA-MRSA，但由于输入病例和在瑞典社区的传播，发病率大幅上升。该策略可称为“搜索和遏制”，因为筛查、感染控制、随访和个人卫生建议是控制的基石，而不是消除携带。
