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Control of MSSA and MRSA in the United States: protocols, policies, risk adjustment and excuses

机译:在美国控制MSSA和MRSA:协议,政策,风险调整和借口

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Data released by the U.S. Centers for Disease Control and Prevention (CDC) on March 5, 2019 showed that Staph aureus infections are a major problem in the United States, with 119,000 infections and almost 20,000 deaths in 2017. Rates of decline for hospital-onset MRSA have slowed since 2012 and the United States is not on track for meeting the 2015?U.S. Dept. of Health and Human Services’ goal of a 50% reduction by 2020. There is a need for improved standards for control of dangerous pathogens. Currently, the World Health Organization’s?recommendation of preoperatively screening patients for Staph aureus?has not become a standard of care in the United States. The U.S. Veterans Health Administration also released data which found a much larger decrease in hospital-onset MRSA infections as opposed to hospital-onset MSSA using various infectious disease bundles that all included universal MRSA surveillance and isolation for MRSA carriers. These results mirror the results obtained by the United Kingdom’s National Health Service. These findings support the contention that the marked decline in hospital-onset MRSA infections observed in these studies is due to interventions which are specifically targeted towards MRSA. A case is made that concerns with the integrity of healthcare policy research, along with industrial conflicts-of-interest?have inhibited effective formulation of infectious disease policy in the United States. Because MRSA has become endemic in the general U.S. population (approximately 2%), the author advocates that universal facility-wide screening of MRSA on admission be included in infection prevention bundles used at U.S. hospital.
机译:美国疾病控制与预防中心(CDC)在2019年3月5日发布的数据显示,金黄色葡萄球菌感染是美国的主要问题,2017年有119,000例感染和近20,000例死亡。医院发病的下降率自2012年以来,MRSA速度有所放缓,美国也未必会达到2015年的水平?卫生与公共服务部的目标是到2020年减少50%。有必要提高控制危险病原体的标准。目前,世界卫生组织关于对患者进行金黄色葡萄球菌术前筛查的建议尚未成为美国的标准护理。美国退伍军人健康管理局还发布了数据,发现与使用各种传染病包的医院发作MSSA相比,医院发作MRSA感染的下降幅度要大得多,这些疾病包都包括通用的MRSA监测和MRSA携带者的隔离。这些结果反映了英国国家卫生局的结果。这些发现支持以下论点:在这些研究中观察到的医院发作的MRSA感染显着下降是由于专门针对MRSA的干预措施。有一个案例表明,在美国,对医疗保健政策研究的完整性以及行业利益冲突的关注已阻碍了传染病政策的有效制定。由于MRSA已成为美国普通人群的流行病(约2%),因此作者主张在美国医院使用的感染预防套装中应包括入院时对MRSA进行的全厂通用筛查。

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