母子医療センターにおけるＭＲＳＡ感染症の発生とその対策

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  • MRSA Nosocomial Infections in Our Perinatal Center and the Procedures of Its Prevention.

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From the beginning of July to the end of September 1999, nine newborn infants in our Perinatal Center showed MRSA infection. Examination of MRSA colonization of all the infants who were born during these 3 months revealed that 59 (61%) of 96 infants were colonized or infected with MRSA. 65 (90.3%) out of 72 MRSA strains obtained from the infants were typed as II AR2B6+, using conventional epidemiological methods such as phenotype, coagulase, anti-microbial susceptibility and TSST;and genotype methods such as DNA restriction length polymorphism. These results strongly suggested nosocomial infection. An infection control committee composed of 5 outside experts was formed to investigate the causes of the MRSA infection and to advise on future eradication and infection management The recommendations and proposals of the committee were as fol-lows: (1) Surveillance of environmental MRSA by applying the air-sampling method in addition to the test of fall-down pathogens, and monitoring of colonization from nasal carriage on every five days. (2) Improvement of hospital equipment and routines;by setting a strict route with a hand-washer between the delivery and neonate room;by installing an isolation ward for infected infants;and by performing scheduled sanitation with a contamination test. (3) Improvement of nursing procedures to establish the one care/one hand-wash rule;to change gowns for different zones from the delivery to neonate room;to use a new bath towel for each individual neonate;and to thoroughly educate all members of staff. We re-opened the delivery care on December 21 st 1999.<br>To date, this new management system has proved satisfactory in the reduction of the MRSA colonization ratio.

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  • 医療

    医療 54 (11), 498-508, 2000

    一般社団法人 国立医療学会

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