Stamm A M, Long M N, Belcher B
Department of Medicine, University of Alabama, Birmingham 35294.
Am J Infect Control. 1993 Apr;21(2):70-4. doi: 10.1016/0196-6553(93)90227-u.
Methicillin-resistant Staphylococcus aureus has become a frequent cause of hospital-acquired infectious disease. However, the impact of methicillin-resistant S. aureus on the overall nosocomial infection rate has not been clearly defined.
The University of Alabama at Birmingham Hospital is a tertiary care facility and participant in the National Nosocomial Infections Surveillance system. Prospective, hospital-wide surveillance for nosocomial infections was conducted for 8 months per year during 1986 through 1991.
The total nosocomial infection rate increased from 4.5% in 1987 to 5.9% in 1990. This was temporally associated with a rise in the attack rate of methicillin-resistant S. aureus from 0% to 0.4%. The remainder of the increase was caused by other gram-positive microorganisms, including methicillin-sensitive S. aureus. We identified methicillin-resistant S. aureus most commonly in the surgical intensive care unit and as a cause of lower respiratory tract infections. In contrast, methicillin-sensitive S. aureus was most frequently found in the neurologic intensive care unit and as the etiologic agent of surgical wound infections.
Methicillin-resistant S. aureus has become a common nosocomial pathogen. There has been no decrease in the attack rate of methicillin-sensitive S. aureus or other gram-positive cocci. The total nosocomial infection rate has increased as a result equally of the emergence of methicillin-resistant S. aureus and of the renewed activity of other gram-positive pathogens. Methicillin-resistant S. aureus has added to the overall burden of nosocomial infectious disease.
耐甲氧西林金黄色葡萄球菌已成为医院获得性传染病的常见病因。然而，耐甲氧西林金黄色葡萄球菌对总体医院感染率的影响尚未明确界定。
阿拉巴马大学伯明翰医院是一家三级医疗机构，也是国家医院感染监测系统的参与者。1986年至1991年期间，每年对医院范围内的医院感染进行8个月的前瞻性监测。
医院感染总发生率从1987年的4.5%上升至1990年的5.9%。这在时间上与耐甲氧西林金黄色葡萄球菌的发病率从0%上升至0.4%相关。其余的增长是由其他革兰氏阳性微生物引起的，包括对甲氧西林敏感的金黄色葡萄球菌。我们在外科重症监护病房最常发现耐甲氧西林金黄色葡萄球菌，它也是下呼吸道感染的病因。相比之下，对甲氧西林敏感的金黄色葡萄球菌最常出现在神经重症监护病房，是手术伤口感染的病原体。
耐甲氧西林金黄色葡萄球菌已成为常见的医院病原体。对甲氧西林敏感的金黄色葡萄球菌或其他革兰氏阳性球菌的发病率并未下降。医院感染总发生率的上升同样是由于耐甲氧西林金黄色葡萄球菌的出现以及其他革兰氏阳性病原体活性的恢复。耐甲氧西林金黄色葡萄球菌增加了医院传染病的总体负担。
