主動鼻腔篩檢措施對加護病房MRSA感染率之影響

Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing health care-associated infections, such as infections of the skin and wounds, osteomyelitis, pneumonia, endocarditis, and bacteremia. Studies have also revealed that infection caused by MRSA increases patient mortality rates and the workload of hospital staff. It is important to reduce health care-associated infections caused by MRSA. We analyzed the epidemiology of nosocomial MRSA infection in a regional hospital and found that 62.4% of MRSA infections occurred in adult intensive care units (ICUs). From the data reported in the literature, we attempted to bring about a 40% reduction in the MRSA infection rate in ICUs. Active nasal MRSA surveillance culture was performed in both adult medical and surgical ICUs from October 1, 1996 through April 30, 1997 for every new patient. The infection control unit notified the ICUs to carry out contact isolation, and decolonization therapy was started for MRSA-positive patients. Eventually, the MRSA infection rate in the ICUs dropped from 2.44% (January to September 2007) to 1.05% (October 2007 to April 2008). Research confirmed that the active nasal screening culture policy, contact isolation measures, and eradication of MRSA colonization could bring about a reduction of 40% in MRSA infection.