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閲覧数:41
ID 32128394
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本文 TohoJMed003001034.pdf
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URI
タイトル Countermeasures Against Methicillin-Resistant Staphylococcus Aureus Transmission: Non-Screening Preemptive Isolation and Cohorting of Patients With Respiratory Tract Devices
別タイトル
著者
Takaharu, Kiribayashi
Division of General and Gastroenterological Surgery (Ohashi), Department of Surgery, School of Medicine, Faculty of Medicine, Toho University
[役割]Author
Shinya, Kusachi
Division of General and Gastroenterological Surgery (Ohashi), Department of Surgery, School of Medicine, Faculty of Medicine, Toho University
[役割]Author
Manabu, Watanabe
Division of General and Gastroenterological Surgery (Ohashi), Department of Surgery, School of Medicine, Faculty of Medicine, Toho University
[役割]Author
Hironobu, Nishimuta
Division of General and Gastroenterological Surgery (Ohashi), Department of Surgery, School of Medicine, Faculty of Medicine, Toho University
[役割]Author
Osahiko, Hagiwara
Division of General and Gastroenterological Surgery (Ohashi), Department of Surgery, School of Medicine, Faculty of Medicine, Toho University
[役割]Author
Yoshihisa, Saida
Division of General and Gastroenterological Surgery (Ohashi), Department of Surgery, School of Medicine, Faculty of Medicine, Toho University
[役割]Author
出版地 Tokyo
出版者 The Medical Society of Toho University
形態
上位タイトル
Toho Journal of Medicine (Toho Journal of Medicine). Vol.3, No.1  (2017. 3) ,p.34- 40
識別番号
ISSN
21891990
DOI
URI
JaLCDOI info:doi/10.14994/tohojmed.2016.011
抄録 Background: Methicillin-resistant Staphylococcus aureus (MRSA) is often isolated in airways of patients with respiratory tract devices (RT-D) after endotracheal intubation or tracheostomy (RT-D patients). Transmission to other patients is frequent. In this study, we investigated the effectiveness of non-screening preemptive isolation and cohorting (NSPEIC) of RT-D patients in our surgical ward. Specifically, we assessed the possibility of preventing transmission to other patients. Methods: We analyzed data from 433 patients: 217 RT-D patients admitted to our surgical ward and 216 postoperative patients who were hospitalized in the surgical ward during the same period, but had not undergone tracheostomy or endotracheal intubation, and had a positive MRSA result for a nonrespiratory specimen, such as a surgical site infection (SSI) (non-RT-D patients). The indications for isolation and cohorting were as follows. During Phases I (September 1987 to February 1990) and III (September 1997 to February 1999), RT-D patients underwent isolation and cohorting after testing revealed MRSA positivity; during Phases II (March 1990 to August 1997) and IV (March 1999 to May 2014), all RT-D patients underwent NSPEIC regardless of MRSA status. During Phase I, MRSA strains were defined as matching when drug-susceptibility pattern, coagulase type, enterotoxin type, toxic shock syndrome toxin-1 production, and phage type all matched. During Phases II through IV, pulsed-field gel electrophoresis was used for identification and matching. Results: During Phase I, 93.1% (27/29) of MRSA cases had matched strains, and this period was therefore classified as “with transmission”. No strains matched during Phase II. During Phase III, 85.7% (18/21) of MRSA cases had matched strains, and this period was also classified as “with transmission”. Similarly, during Phase IV, 4.7% (2/43) of MRSA cases had matched strains, and this period was classified as “with transmission”. Matching rates were significantly lower for Phases II and IV than for Phases I and III. Conclusions: NSPEIC appears effective in preventing MRSA transmission among RT-D patients in a surgical ward.
キーワード
methicillin-resistant Staphylococcus aureus (MRSA)
isolation
cohorting
colonization
pulsed-field gel electrophoresis (PFGE)
NDC
注記 Original Article
言語
eng
資源タイプ TOHO University Scholarly Publication
ジャンル Journal Article
著者版フラグ publisher
アクセス条件 東邦大学医学会
Index
/ Public / Toho Journal of Medicine / Vol.3 / No.1(p.1-49)
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