主动监测培养对于控制院内MRSA感染的效果

Effectiveness of active surveillance cultures on controlling hospital MRSA infections

目的探讨主动监测培养对于住院患者耐甲氧西林金黄色葡萄球菌（MRSA）感染控制情况的效果。方法统计沈阳军区总医院2011-2013年MRSA培养阳性率、感染率等相关数据,以6个月为单位,对实施主动监测培养前后各时间段情况进行比较。结果实施监测培养后MRSA培养阳性人数一度增加,由原平均每月不足10人,增至2012年下半年的平均约12人/月。后逐渐下降,2013年下半年降至约平均9人/月,与2012年上半年相比,差异有统计学意义（P〈0.05）。MRSA感染发病率在实施监测培养后呈下降趋势,由最初1.3‰-1.4‰降至2013年下半年的0.49‰,该数值与2013年上半年相比差异有统计学意义（P〈0.05）。抗MRSA抗生素使用量在引入监测培养后减少。2013年下半年用量降至约平均65支/月,与2013年上半年相比,差异有统计学意义（P〈0.05）。结论主动检测培养为院内原有MRSA感染检测的重要补充。若MRSA筛查培养阳性可早期采取相应干预手段,有效防止院内感染发生,促进了抗生素的合理应用。

Objective To discuss the effectiveness of active surveillance cultures on controlling MRSA infections in inpatients. Methods The rate of MRSA positive culture, infection incidence and other relevant data before and after the introduction of active surveillance cultures were compared and analyzed. Results After the introduction of active surveillance cultures, the number of MRSA carriers increased at first from the original less than 10 cases to about 12 cases per month, then significantly decreased to an average of 9 persons per month. The incidence of MRSA infections decreased from 1.3%0 to 1.4%0 in 2011 and 2012 to 0.49%0 in the second half of 2013. The amount of anti-MRSA antibiotics decreased significantly in the latter half of 2013 to about 65 ampoules per month. Conclusion Active surveillance cultures are important supplement methods to the existing MRSA infection detections. The active surveillance culture program for high-risk patients is effective on preventing the spread of MRSA and helpful for rational antibiotics use.