Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA 99164, USA.
Int J Environ Res Public Health. 2020 Feb 26;17(5):1500. doi: 10.3390/ijerph17051500.
Healthcare-associated transmission of methicillin-resistant Staphylococcus aureus (MRSA)remains a persistent problem. The use of chlorhexidine gluconate (CHG) as a means of decolonizingpatients, either through targeted decolonization or daily bathing, is frequently used to supplementother interventions. We explore the potential of a long-acting disinfectant with a persistent effect,immediate decolonizing action in the prevention of MRSA acquisition, and clinical illness andmortality in an 18-bed intensive care unit, based on a previous model. A scenario with nointervention is compared to CHG bathing, which decolonizes patients but provides no additionalprotection, and a hypothetical treatment that both decolonizes them and provides protection fromsubsequent colonization. The duration and effectiveness of this protection is varied to fully explorethe potential utility of such a treatment. Increasing the effectiveness of the decolonizing agentreduces colonization, with a 10% increase resulting in a colonization rate ratio (RR) of 0.89 (95% CI:0.89,0.90). Increasing the duration of protection results in a much more modest reduction, with a 12-hour increase in protection resulting in an RR of 0.99 (95% CI: 0.99, 0.99). There is little evidence ofsynergy between the two.
耐甲氧西林金黄色葡萄球菌（MRSA）的医院感染传播仍然是一个持续存在的问题。使用葡萄糖酸洗必泰（CHG）对患者进行定植消除（通过目标性定植消除或每日沐浴），常被用来补充其他干预措施。我们基于之前的模型，探讨了一种长效消毒剂在预防 18 张病床的重症监护病房中获得 MRSA 感染、临床发病和死亡方面的潜在作用，这种消毒剂具有持久的作用和立即的定植消除作用。将无干预情景与仅能定植消除但不能提供额外保护的 CHG 沐浴进行比较，并假设一种治疗方法可以定植消除并提供后续定植保护。改变保护的持续时间和有效性来充分探索这种治疗方法的潜在用途。增加定植消除剂的有效性可降低定植率，定植率的 10%增加导致比值比（RR）为 0.89（95%CI：0.89，0.90）。延长保护持续时间只会导致适度降低，保护时间延长 12 小时，RR 为 0.99（95%CI：0.99，0.99）。两者之间几乎没有协同作用的证据。
