Screening and control of methicillin-resistant Staphylococcus aureus in 186 intensive care units different situations and individual solutions 英文参考文献.docVIP

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Screening and control of methicillin-resistant Staphylococcus aureus in 186 intensive care units different situations and individual solutions 英文参考文献.doc

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Screening and control of methicillin-resistant Staphylococcus aureus in 186 intensive care units different situations and individual solutions 英文参考文献

Kohlenbergetal.CriticalCare2011,15:R285 /content/15/6/R285 RESEARCH OpenAccess Screeningandcontrolofmethicillin-resistant Staphylococcusaureusin186intensivecareunits: differentsituationsandindividualsolutions AnkeKohlenberg1*,FrankSchwab2,3,MichaelBehnke2,3,ChristineGeffers2,3 andPetraGastmeier2,3 Abstract Introduction:Controversyexistsaboutthebenefitofscreeningforpreventionofmethicillin-resistant Staphylococcusaureus(MRSA)inintensivecareunits(ICUs)andrecentstudieshaveshownconflictingresults.The aimofthisobservationalstudywastodescribeandevaluatetheassociationbetweenMRSAincidencedensities (IDs)andscreeningandcontrolmeasuresinICUsparticipatingintheGermanNosocomialInfectionSurveillance System. Methods:Thesurveillancemoduleformultidrug-resistantbacteriacollectsdataonMRSAcasesinICUswiththe aimtoprovideanationalreferenceandatoolforevaluationofinfectioncontrolmanagement.ThemedianIDsof MRSAcasesper1000patient-days(pd)withtheinterquartilerange(IQR)werecalculatedfromthepooleddataof 186ICUsandcorrelatedwithparametersderivedfromadetailedquestionnaireregardingICUstructure, microbiologicaldiagnosticsandMRSAscreeningandcontrolmeasures.Theassociationbetweenquestionnaire resultsandMRSAcaseswasevaluatedbygeneralizedlinearregressionmodels. Results:Onehundredeighty-sixICUssubmitteddataonMRSAcasesfor2007and2008andcompletedthe questionnaire.Duringtheperiodofanalysis,4935MRSAcasesoccurredintheseICUs;ofthese,3928(79.6%)were importedand1007MRSAcases(20.4%)wereICU-acquired.MedianMRSAIDswere3.23(IQR1.24-5.73),2.24(IQR 0.63-4.30)and0.64(IQR0.17-1.39)per1000pdforallcases,importedandICU-acquiredMRSAcases,respectively. MRSAIDsaswellasimplementedMRSAscreeningandcontrolmeasuresvariedwidelybetweenICUs.ICUs performinguniversaladmissionscreeninghadsignificantlyhigherMRSAIDsthanICUsperformingtargetedorno screening.SeparateregressionmodelsforICUswithdifferentscreeningstrategiesincludedtheincidenceof importedMRSAcases,thetypeofICU,andthelengthofstayinindependentassociationwiththenumberofICU- acqui