常规监测和去定植对四级新生儿重症监护病房金黄色葡萄球菌感染率的影响。
The effect of routine surveillance and decolonization on the rate of Staphylococcus aureus infections in a level IV neonatal intensive care unit.
作者信息
Balamohan Archana, Beachy Joanna, Kohn Nina, Rubin Lorry G
机构信息
Cohen Children's Medical Center of New York, Northwell Health, New York, NY, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
出版信息
J Perinatol. 2020 Nov;40(11):1644-1651. doi: 10.1038/s41372-020-0755-5. Epub 2020 Aug 8.
OBJECTIVE
To evaluate the impact of active surveillance cultures (ASC) for Staphylococcus aureus (SA) and decolonization on the rate of infection in neonates in a neonatal intensive care unit (NICU).
STUDY DESIGN
Using a quasi-experimental design with control groups, rates of SA infections before and after implementing weekly ASC and topical mupirocin decolonization in a level IV NICU were compared. Comparators were the rates of gram negative bloodstream infections (BSI) and of SA BSI at an affiliated NICU where the intervention was not implemented.
RESULT
There was a 77% (p < 0.010) reduction in rate of NICU-wide methicillin-susceptible SA (MSSA) BSI, but no significant change in rate of methicillin-resistant SA BSI, likely due to a prevalent mupirocin-resistant clone. Rates of gram negative BSI and SA BSI at an affiliated NICU did not change significantly.
CONCLUSION
Weekly ASC and decolonization were associated with a unit-wide reduction in MSSA infections in a NICU.
目的
评估主动监测培养（ASC）检测金黄色葡萄球菌（SA）及去定植对新生儿重症监护病房（NICU）新生儿感染率的影响。
研究设计
采用带有对照组的准实验设计，比较在一家四级NICU实施每周一次的ASC及局部应用莫匹罗星去定植前后SA感染率。对照为未实施该干预措施的附属NICU的革兰阴性血流感染（BSI）率及SA BSI率。
结果
全NICU范围内甲氧西林敏感SA（MSSA）BSI率降低了77%（p < 0.010），但耐甲氧西林SA BSI率无显著变化，可能是由于存在普遍的耐莫匹罗星克隆。附属NICU的革兰阴性BSI率及SA BSI率无显著变化。
结论
每周一次的ASC及去定植与NICU内全病房范围的MSSA感染减少有关。
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