降低新生儿重症监护病房的金黄色葡萄球菌感染。
Reducing Staphylococcus aureus infections in the neonatal intensive care unit.
机构信息
Maternal, Fetal, and Neonatal Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.
Infection Prevention, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.
出版信息
J Perinatol. 2022 Nov;42(11):1540-1545. doi: 10.1038/s41372-022-01407-4. Epub 2022 Apr 29.
OBJECTIVE
Our neonatal intensive care unit (NICU) saw an increase in Staphylococcus aureus (SA) infections-methicillin-resistant SA (MRSA) infections increased from 2.1/10,000 patient days (PD) to 5.1/10,000 PD, and methicillin-sensitive SA (MSSA) infections from 1.2/10,000 PD to 3.9/10,000 PD. This quality improvement project aimed to decrease the rates of SA infections to less than 2.0/10,000 PD, and to determine the rate of SA decolonization.
METHODS
Infection prevention interventions targeted patient factors (SA surveillance, patient cohorting, decolonization protocol), provider factors (provider cohorting, enhanced hand hygiene) and environmental factors (room structure, equipment optimization).
RESULTS
The rates of MRSA and MSSA infections decreased to 0.6/10,000 PD and 0.7 infections/10,000 PD respectively. Persistent decolonization of SA was successful in 67% of colonized patients.
CONCLUSIONS
Specific interventions targeting patient, provider, and environmental factors, including the implementation of a SA decolonization protocol, were successful in decreasing the incidence of SA infections in neonates.
目的
我们的新生儿重症监护病房（NICU）中金黄色葡萄球菌（SA）感染——耐甲氧西林金黄色葡萄球菌（MRSA）感染从 2.1/10000 患者日（PD）增加到 5.1/10000 PD，甲氧西林敏感金黄色葡萄球菌（MSSA）感染从 1.2/10000 PD 增加到 3.9/10000 PD。这项质量改进项目旨在将 SA 感染率降低到 2.0/10000 PD 以下，并确定 SA 去定植率。
方法
感染预防干预措施针对患者因素（SA 监测、患者分组、去定植方案）、医务人员因素（医务人员分组、加强手卫生）和环境因素（房间结构、设备优化）。
结果
MRSA 和 MSSA 感染率分别降至 0.6/10000 PD 和 0.7 感染/10000 PD。67%定植的患者成功进行了持续的 SA 去定植。
结论
针对患者、医务人员和环境因素的具体干预措施，包括实施 SA 去定植方案，成功降低了新生儿中 SA 感染的发生率。
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