医院感染控制中耐甲氧西林金黄色葡萄球菌筛查现状-传染病信息.PDF

·54 · Infect Dis Info, 2009, Vol.22, No.1 医院感染控制中耐甲氧西林金黄色葡萄球菌筛查现状 吴文娟①② 汤一苇② ①上海市（复旦大学附属）公共卫生临床中心 上海 201508 ②美国范德堡大学医学中心 那什维尔 37232 摘 要 由于耐甲氧西林金黄色葡萄球菌（methicillin- resistant Staphylococcus aureus ，MRSA）在医院和社区的感染人数快 速增加，MRSA 医院内感染的预防和控制迫在眉睫。目前，MRSA 筛查技术包括标准培养、显色鉴定培养基和基于PCR 的快速检 测技术。用于MRSA 筛查的方法测试周期应低于24 h ，且能在包含甲氧西林耐药凝固酶阴性葡萄球菌和甲氧西林敏感金黄色 葡萄球菌的混合菌群中鉴别MRSA。MRSA 筛查结果可指导接触预防感染控制措施的执行。然而，“MRSA 筛查－接触预防”感 染控制策略受较多因素影响，几项大规模前瞻性观察研究显示MRSA 快速筛查能否预防MRSA 传播和感染尚有争议。医院内 MRSA 筛查并不能阻止抗生素耐药的发展和MRSA 的进化，其目的是降低医院内感染率和避免患者严重感染。 关键词 耐甲氧西林金黄色葡萄球菌；筛查；感染控制 中图分类号： 文献标识码： 文章编号： R378.11 A 1007-8134(2009)01-0054-04 MRSA screening in nosocomial infection control: state-of-the-art Wu Wenjuan①②, Tang Yiwei② ①Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China Abstract Disease burden caused by methicillin-resistant Staphylococcus aureus (MRSA) in both hospital and community set－ tings has been escalating, so prevention and control strategies are receiving increased attention. Currently available screening methods for MRSA include standard culture, several commercially available chromogenic agar media and PCR-based testing. An ideal MRSA screening method can provide test results within 24 hours with abilities to identify MRSA from mixed flora of methicillin-resistant co － agulase-negative staphylococci and MRSA. A positive MRSA screening result warrants a contact isolation. However, prevention and control strategies including MRSA screening and contact isolation are influenced by many factors and several prospective studies sug－ gest whether rapid screening for MRSA prevents its transmission and decr