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医院耐甲氧西林金黄色葡萄球菌的控制:法国经验。卢瓦尔河地区国家消除医院感染协会。

Methicillin-resistant Staphylococcus aureus control in hospitals: the French experience. Association des Pays de la Loire pour l'Eviction des Infections Nosocomiales.

作者信息

Richet H, Wiesel M, Le Gallou F, André-Richet B, Espaze E

机构信息

Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Centre Hospitalier Universitaire de Nantes, France.

出版信息

Infect Control Hosp Epidemiol. 1996 Aug;17(8):509-11. doi: 10.1086/647353.

Abstract

The first cases of isolation of Staphylococcus aureus resistant to methicillin in France were published in 1962. However, until recently, very few epidemiological studies or attempts to control the epidemic have been done in France. In this article, we present the results of a prospective study performed during a 3-month period in 27 hospitals of the Région des Pays de la Loire. Among the 94,605 hospitalized patients included in the study, 0.45% (427) developed methicillin-resistant Staphylococcus aureus (MRSA) infections, the incidence rate ranging from 0% to 1.2%. Thirty-four percent of MRSA-infected patients were 80 years old or older, 30% had been transferred from another service and 19% from another hospital, 56% were hospitalized at least once during the previous year, MRSA had been isolated at least once previously in 18% of MRSA-infected patients, 19% died, 16% were transferred to another service and 11% to another hospital, and only 32% were discharged to their homes. A poor compliance to contact isolation precautions was observed in all hospitals: 46% of MRSA-infected patients were hospitalized in a private room; gloves, masks, and gowns were worn for the care of 63.4%, 14%, and 42.5% of MRSA-infected patients, respectively; and handwashing was feasible in the rooms of 52% of the patients.

摘要

法国首例耐甲氧西林金黄色葡萄球菌分离病例于1962年发表。然而,直到最近,法国开展的流行病学研究或控制疫情的尝试都非常少。在本文中,我们展示了在卢瓦尔河地区27家医院进行的为期3个月的前瞻性研究结果。在纳入研究的94,605名住院患者中,0.45%(427例)发生了耐甲氧西林金黄色葡萄球菌(MRSA)感染,发病率在0%至1.2%之间。34%的MRSA感染患者年龄在80岁及以上,30%曾从其他科室转入,19%从其他医院转入,56%在前一年至少住院一次,18%的MRSA感染患者此前至少有一次分离出MRSA,19%死亡,16%转入其他科室,11%转入其他医院,只有32%出院回家。所有医院对接触隔离预防措施的依从性都很差:46%的MRSA感染患者被安置在单人病房;在护理MRSA感染患者时,分别有63.4%、14%和42.5%的患者佩戴了手套、口罩和穿了隔离衣;52%的患者病房具备洗手条件。

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