F大学病院および呼吸器内科病棟のMRSA排菌者の推移と感染予防対策

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  • F ダイガク ビョウイン オヨビ コキュウキ ナイカ ビョウトウ ノ MRSAハイキンシャ ノ スイイ ト カンセン ヨボウ タイサク
  • Methicillin-resistant Staphylococcus aureus incidence and infection control measures in a respiratory care unit at F Medical University Hospital

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A plan for infection control measures and nursing management was formulated to prevent the outbreak of methicillin-resistant Staphylococcus aureus (MRSA). The effectiveness of the plan was tested between 1984 and 1999 in a respiratory care unit. In F Medical University Hospital, the first case of MRSA was detected in 1984. In 1987, a MRSA infection control committee was formed in the hospital. Despite countermeasures, the number of MRSA cases increased until 1991. MRSA was isolated in laboratory cultures on 130 patients. Thirty one (22.7%) patients out of the 130 were diagnosed as being either MRSA pneumonia or septicemia, and were treated intensively with multiple antibiotics. The remaining 99 patients, including 52 (40%) with lung cancer, were diagnosed as uninfected carriers. Following-minor outbreaks in 1992 and 1993, all staff in the target unit adhered to strict infection control guidelines, as follows: 1. open-wound gown and glove technique, 2. hand washing 3. patient and family education, and 4. judicious use of antibiotics, venous and urethral catheterization, and tracheotomy. Following application of these guidelines, the number of MRSA cases decreased. Results in this study suggest the need for improved in-service-training of new staff.

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