- 期刊
Investigation and Elimination of Epidemic Methicillin-Resistant Staphylococcus Aureus in a Neonatal Intensive Care Unit
新生兒加護病房methicillin抗藥性金黃色葡萄球菌流行之調查與根除
摘要
為調查最近在某大教學醫院新生兒加護病房發生之methicillin抗藥性金黃色葡萄球菌(MRSA)流行，我們收集25株MRSA菌株做研究，其中16株為由病人檢體分離出來，9株由醫護人員前鼻腔篩檢獲得。本研究以抗生素圖譜和核酸限制酶分析質體(plasmid) DNA的方法調查菌株間之相關性，並依此研擬根除MRSA院內感染之策略。 結果發現25株MRSA可分成四種質體型態(I-IV)，各有7、8、2、8菌株。其中有6株由病人檢體分離出來之MRSA質體型態和醫護人員之帶菌者相同(I & II)。新生兒加護病房MRSA院內感染最主要之散播方式是經由醫護人員之手接觸造成病人間之流行。我們以嚴密的監視及感染控制措施成功的控制並根除MRSA流行，其策略包括：(l)嚴密的隔離惜施和世代追蹤(cohort-ing)；(2)加強洗手措施以預防病人間之散佈與感染；(3)以安全有效的抗生素藥膏（如mupirocin）治療醫護人員和病人中之帶菌者。
關鍵字
無資料並列摘要
A recent outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in neonatal intensive care unit (NICU) in a teaching hospital was investigated. A total of 25 MRSA isolates, 16 from the patients and nine from the staffs (carriers), was collected for the study. The possible relationship among the isolates was investigated by using antibiograms and restriction enzyme analysis of plasmid DNA. Control strategy of the MRSA nosocomial infection was proposed after the study of antibiograms and plasmid profile. There were four plasmid patterns (I-IV), each containing 7, 8, 2, and 8 isolates. Six of the 16 isolates from the patients had identical plasmid patterns as the carriers (I and II). Person to person transfer via hand contact by medical personnel was found to be the most frequent mode of transmission identified in the outbreak of MRSA nosocomial injection in the NICU: Our strategy for control of the outbreak and elimination of the MRSA from all patients and carriers was successful after intensive surveillance and control measures. These included (a) strict isolation and cohorting; (b) hand washing between patient contacts to prevent transmission; (c) treatment of the carrier state in health care workers and patients with safe and effective topical agents such as mupirocin.
延伸閱讀
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- 楊惠茹、戴金英（2020）。探討外科加護病房患者抗Methicillin金黃色葡萄球菌移生盛行率與其相關因素。秀傳醫學雜誌，19(1)，38-52。https://doi.org/10.3966/156104972020061901004
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