Tan K W, Tay L, Lim S H
Department of Neonatal Medicine II, Kandang Kerbau Hospital, Singapore.
Singapore Med J. 1994 Jun;35(3):277-82.
Methicillin resistant Staphylococcus aureus (MRSA) is a major infection control problem in many countries. There have been many reports of outbreaks in neonatal nurseries including, in our part of the world, Australia, Hong Kong and Malaysia. A recent outbreak of MRSA in the neonatal intensive care unit in the Kandang Kerbau Hospital, Singapore, presented us with the opportunity to study the clinical characteristics of the outbreak and the effects of infection control measures. Neonates admitted to the neonatal intensive care unit were studied over a 20-month period. They were all screened for nasal colonisation on admission and weekly thereafter. Infections were documented. Over this period there were altogether 2,576 admissions of which 85 infants had nasal colonisation with MRSA (3.3%) and 28 developed infections (1%). Although the majority of infants colonised by MRSA suffered no ill effects, 3 had septicaemia and 2 had septicaemia with osteomyelitis. There were no deaths. Standard infection control measures with barrier nursing and the use of mupirocin nasal ointment were ineffective, and control was achieved only after strict cohorting together with the use of mupirocin was instituted. This was done without additional costs to the department and without additional nurses or doctors.
耐甲氧西林金黄色葡萄球菌（MRSA）在许多国家都是一个重大的感染控制问题。已有许多关于新生儿重症监护病房爆发疫情的报道，包括在我们所在的地区，如澳大利亚、香港和马来西亚。新加坡康当格宝医院新生儿重症监护病房最近爆发的MRSA疫情，为我们提供了研究疫情临床特征以及感染控制措施效果的机会。对入住新生儿重症监护病房的新生儿进行了为期20个月的研究。他们入院时以及此后每周都进行鼻腔定植筛查。记录感染情况。在此期间，共有2576名新生儿入院，其中85名婴儿鼻腔定植有MRSA（3.3%），28名发生感染（1%）。虽然大多数定植有MRSA的婴儿没有受到不良影响，但有3名发生败血症，2名发生败血症合并骨髓炎。无死亡病例。采用屏障护理和使用莫匹罗星鼻软膏的标准感染控制措施无效，只有在实施严格的分组护理并使用莫匹罗星后才实现了控制。这样做没有给科室增加额外费用，也没有增加护士或医生。
