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首页> 外文期刊>Infection control and hospital epidemiology >Methicillin-resistant Staphylococcus aureus in German intensive care units during 2000-2003: data from Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units).
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Methicillin-resistant Staphylococcus aureus in German intensive care units during 2000-2003: data from Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units).

机译：2000-2003年期间德国重症监护病房的耐甲氧西林金黄色葡萄球菌：来自SARI项目（重症监护病房的抗菌药物使用和耐药性监测）的数据。

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OBJECTIVES: The objective of this study was to analyze methicillin-resistant Staphylococcus aureus (MRSA) percentages (defined as the percentage of S. aureus isolates that are resistant to methicillin) and antimicrobial consumption in intensive care units (ICUs) participating in Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units), to look for temporal changes in MRSA percentages and antimicrobial consumption in individual ICUs as an indicator of the impact of an active surveillance system, and to investigate the differences between ICUs with increased MRSA percentages versus those with decreased percentages during a period of 3 years (2001-2003). METHODS: This was a prospective, ICU-based and laboratory-based surveillance study involving 38 German ICUs during 2000-2003. Antimicrobial use was reported in terms of defined daily doses (DDDs) per 1,000 patient-days. Temporal changes in the MRSA percentage and antimicrobial use in individual ICUs were calculated by means of the Wilcoxon signed rank test. The incidence density of nosocomial MRSA infection was defined as the number of nosocomial MRSA infections per 1,000 patient-days. RESULTS: From February 2000 through December 2003, a total of 38 ICUs reported data on 499,694 patient-days and 9,552 S. aureus isolates, including 2,249 MRSA isolates and 660,029 DDDs of antimicrobials. Cumulative MRSA percentages ranged from 0% to 64.4%, with a mean of 23.6%. The MRSA incidence density ranged from 0 to 38.2 isolates per 1,000 patient-days, with a mean of 2.77 isolates per 1,000 patient-days. There was a positive correlation between MRSA percentage and imipenem and ciprofloxacin use (P<.05). Overall, comparison of data from 2001 with data from 2003 showed that MRSA percentages increased in 18 ICUs (median increase, 13.2% [range, 1.6%-38.4%]) and decreased in 14 ICUs (median decrease, 12% [range, 1.0%-48.4%]). Increased use of third-generation cephalosporins, glycopeptides, or aminoglycosides correlated significantly with an increase in the MRSA percentage (P<.05). The cumulative nosocomial MRSA infection incidence density for 141 ICUs that did not participate in SARI and, therefore, did not receive feedback increased from 0.26 to 0.35 infections per 1,000 patient-days during a 3-year period, whereas the rate in SARI ICUs decreased from 0.63 to 0.40 infections per 1,000 patient-days. CONCLUSION: The MRSA situation in German ICUs is still heterogeneous. Because MRSA percentages range from 0% to 64.4%, further studies are required to confirm findings that no change in the MRSA percentage and a decrease in the nosocomial MRSA infection incidence density in SARI ICUs reflect the impact of an active surveillance system.
机译：目的：本研究的目的是分析耐甲氧西林金黄色葡萄球菌（MRSA）百分比（定义为耐甲氧西林金黄色葡萄球菌分离株的百分比）和参与SARI项目的重症监护病房（ICU）的抗菌药物消费量（对重症监护病房的抗菌药物使用和抗菌素耐药性进行监测），以查找各个ICU中MRSA百分比和抗菌药物消耗的时间变化，以此作为主动监测系统的影响指标，并调查MRSA百分比增加的ICU之间的差异与在3年内（2001-2003年）百分比下降的人相比。方法：这是一项前瞻性，基于ICU和实验室的监测研究，涉及2000至2003年间的38个德国ICU。据报告，每千名患者每天使用抗微生物药物的每日定义剂量（DDD）。各个ICU中MRSA百分比和抗菌药物使用的时间变化通过Wilcoxon符号秩和检验进行计算。医院内MRSA感染的发生密度定义为每1,000个患者日的医院内MRSA感染数。结果：从2000年2月到2003年12月，总共38个ICU报告了499694个患者日和9552个金黄色葡萄球菌分离株的数据，包括2249个MRSA分离株和660029 DDDs的抗菌药物。 MRSA累积百分比范围从0％到64.4％，平均为23.6％。每1000个病人日的MRSA发生密度为0到38.2个分离株，平均每1000个病人日为2.77个分离株。 MRSA百分比与亚胺培南和环丙沙星使用之间呈正相关（P <.05）。总体而言，将2001年与2003年的数据进行比较，结果显示MRSA百分比在18个ICU中增加（中位数增加13.2％[范围，1.6％-38.4％]），在14个ICU中减少（中位数减少12％[范围，1.0） ％-48.4％]）。第三代头孢菌素，糖肽或氨基糖苷的使用增加与MRSA百分比的增加显着相关（P <.05）。 141个未参加SARI并因此未收到反馈的ICU的累积医院MRSA感染发生密度在3年期间从每1000个患者日的0.26感染增加到0.35感染，而SARI ICU的发生率从每1,000个病人日0.63至0.40个感染。结论：德国重症监护病房的MRSA情况仍然不统一。由于MRSA百分比范围从0％到64.4％，因此需要进一步研究以确认发现，SARI ICU中MRSA百分比没有变化以及医院内MRSA感染发生率的降低反映了主动监视系统的影响。

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