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The significance of methicillin-resistant Staphylococcus aureus infection in general surgery: a multivariate analysis of risk factors and preventive approaches.

作者信息

Shimada M, Kamakura T, Itasaka H, Matsumata T, Hashizume M, Sugimachi K

机构信息

Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Surg Today. 1993;23(10):880-4. doi: 10.1007/BF00311366.

DOI:10.1007/BF00311366
PMID:8298233
Abstract

To investigate the characteristics, risk factors, and prevention of methicillin-resistant Staphylococcus aureus (MRSA), a total of 3,627 patients were studied. Among these, 1,336 patients with various infections were used in a risk factor analysis of MRSA to determine the relationship between the use of antibiotics and the incidence of MRSA. Only 3.0% of infections were attributed to MRSA, the esophagus and colorectal region being highly involved, as anastomotic or pelvic abscesses, while the lung had a lower incidence. Almost half the patients with MRSA infections (47.6%) had concomitant infection. A univariate analysis revealed the following significant factors: The coexistence of gastrointestinal or metastatic malignancy, sepsis, tracheostomy, and the prior use of antibiotics such as the beta-lactam compounds or aminoglycosides. A multivariate analysis showed that gastrointestinal malignancy, sepsis, and the prior use of aminoglycosides, tetracycline, macrolides, and carbapenems were independently significant factors. To promote the education of doctors and nurses, regular in-service meetings on MRSA were held in the ward. Moreover, preventive approaches such as patient isolation, strategically placed hand washing equipment, and the use of disposable gloves and contaminated waste bags, have been initiated, and the incidence of MRSA has decreased significantly since then. Thus, to control MRSA, the following steps should be taken: (1) constant and careful surveillance, (2) regular risk factor analyses, (3) the optimal administration of antibiotics, and (4) the education of all hospital staff.

摘要

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本文引用的文献

1
Subinhibitory concentrations of imipenem induce increased resistance to methicillin and imipenem in vitro in methicillin-resistant Staphylococcus aureus.亚抑菌浓度的亚胺培南在体外可诱导耐甲氧西林金黄色葡萄球菌对甲氧西林和亚胺培南产生耐药性增加。
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Staphylococcus aureus. The persistent pathogen (first of two parts).金黄色葡萄球菌。持续性病原体(两部分中的第一部分)。
N Engl J Med. 1984 May 24;310(21):1368-73. doi: 10.1056/NEJM198405243102107.
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耐甲氧西林金黄色葡萄球菌的国际传播
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[Analysis of methicillin-cephem resistant Staphylococcus aureus (MRSA) hospital infection and toxigenicity of MRSA].耐甲氧西林头孢菌素金黄色葡萄球菌(MRSA)医院感染及MRSA产毒性分析
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[Methicillin-resistant Staphylococcus aureus (MRSA) infection--significance of MRSA in respiratory tract infection].[耐甲氧西林金黄色葡萄球菌(MRSA)感染——MRSA在呼吸道感染中的意义]
Rinsho Byori. 1990 Sep;38(9):1005-15.
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Singapore Med J. 1991 Feb;32(1):17-9.