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首页> 外文期刊>The Journal of Antimicrobial Chemotherapy >Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: a time-series analysis.
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Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: a time-series analysis.

机译：建模抗生素使用和感染控制措施对医院获得的耐甲氧西林金黄色葡萄球菌发生率的影响：时间序列分析。

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OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. A wide range of factors have been suggested to influence the spread of MRSA. The objective of this study was to evaluate the effect of antimicrobial drug use and infection control practices on nosocomial MRSA incidence in a 426-bed general teaching hospital in Northern Ireland. METHODS: The present research involved the retrospective collection of monthly data on the usage of antibiotics and on infection control practices within the hospital over a 5 year period (January 2000-December 2004). A multivariate ARIMA (time-series analysis) model was built to relate MRSA incidence with antibiotic use and infection control practices. RESULTS: Analysis of the 5 year data set showed that temporal variations in MRSA incidence followed temporal variations in the use of fluoroquinolones, third-generation cephalosporins, macrolides and amoxicillin/clavulanic acid (coefficients = 0.005, 0.03, 0.002 and 0.003, respectively, with various time lags). Temporal relationships were also observed between MRSA incidence and infection control practices, i.e. the number of patients actively screened for MRSA (coefficient = -0.007), the use of alcohol-impregnated wipes (coefficient = -0.0003) and the bulk orders of alcohol-based handrub (coefficients = -0.04 and -0.08), with increased infection control activity being associated with decreased MRSA incidence, and between MRSA incidence and the number of new patients admitted with MRSA (coefficient = 0.22). The model explained 78.4% of the variance in the monthly incidence of MRSA. CONCLUSIONS: The results of this study confirm the value of infection control policies as well as suggest the usefulness of restricting the use of certain antimicrobial classes to control MRSA.
机译：目的：耐甲氧西林金黄色葡萄球菌（MRSA）是全世界主要的医院病原体。已提出影响MRSA传播的多种因素。这项研究的目的是评估北爱尔兰一家有426张病床的普通教学医院的抗菌药物使用和感染控制措施对医院MRSA发病率的影响。方法：本研究涉及过去五年（2000年1月至2004年12月）在医院内使用抗生素和感染控制措施的每月数据的回顾性收集。建立了多元ARIMA（时间序列分析）模型，以将MRSA发生率与抗生素使用和感染控制措施联系起来。结果：对5年数据的分析表明，在使用氟喹诺酮类药物，第三代头孢菌素，大环内酯类药物和阿莫西林/克拉维酸的使用中，MRSA发生率的时间变化随时间变化而变化（系数分别为0.005、0.03、0.002和0.003，各种时滞）。还观察到了MRSA发生率与感染控制措施之间的时间关系，即积极筛查MRSA的患者人数（系数= -0.007），使用浸有酒精的湿巾（系数= -0.0003）和大量使用酒精手擦（系数= -0.04和-0.08），感染控制活性的提高与MRSA发病率降低相关，并且在MRSA发病率与MRSA入院新患者人数之间（系数= 0.22）。该模型解释了MRSA月发生率变异的78.4％。结论：这项研究的结果证实了感染控制政策的价值，并提出了限制某些抗菌剂类用于控制MRSA的有用性。

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