Crit Care Med：ICU中成人耐甲氧西林金黄色葡萄球菌预防的建议

2017-05-07 MedSci MedSci原创

ICU中的患者发生医疗相关感染（如耐甲氧西林的金黄色葡萄球菌）的风险较高。近期，一项发表在杂志Crit Care Med上的研究评估了耐甲氧西林金黄色葡萄球菌的预防策略的成本效益，并基于筛选实验提出了具体策略。此项研究从医院的角度，使用马尔可夫模型的成本效益分析，以确定通过降低耐甲氧西林金黄色葡萄球菌感染和改善质量调整生命年，耐甲氧西林金黄色葡萄球菌预防策略的实施成本是否合适。使用单变量和概率敏感

ICU中的患者发生医疗相关感染（如耐甲氧西林的金黄色葡萄球菌）的风险较高。近期，一项发表在杂志Crit Care Med上的研究评估了耐甲氧西林金黄色葡萄球菌的预防策略的成本效益，并基于筛选实验提出了具体策略。

此项研究从医院的角度，使用马尔可夫模型的成本效益分析，以确定通过降低耐甲氧西林金黄色葡萄球菌感染和改善质量调整生命年，耐甲氧西林金黄色葡萄球菌预防策略的实施成本是否合适。使用单变量和概率敏感性分析确定输入变化对成本效益的影响。

此项研究的人群为ICU的成人患者。

此项研究评估了三项预防策略，包括普遍去除定植，有针对性的去除定植，以及筛选和分离。由于预防策略具有筛选成分，因此模型中的筛选试验是多种多样的，以反映常用的筛选试验类别，包括常规培养，显色琼脂和聚合酶链反应。

此项研究结果显示：普遍和有针对性的去除定植成本较低，并且比筛选和隔离更有效。这对于所有筛选测试都是一致的。与针对性的去除定植相比，普通去除定植的成本效益高，当医院使用更为昂贵的筛选试验如聚合酶链反应时，可以节省成本。结果的敏感性分析也是稳健的。

此项研究表明：与筛选和隔离相比，目前ICU的标准做法，有针对性的去除定植和普遍的去除定植成本较低，并且更有效。

原始出处：
Whittington MD, Atherly AJ, et al. Recommendations for Methicillin-Resistant Staphylococcus aureus Prevention in Adult ICUs: A Cost-Effectiveness Analysis. Crit Care Med. 2017 May 3. doi: 10.1097/CCM.0000000000002484.

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2017-05-24 惠映实验室

减少感染的可能

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2017-05-09 jambiya

#金黄色葡萄球菌#

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2017-05-09 手留余香

#葡萄球菌#

25 0
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2017-05-09 ms3994565386320060

#Med#

34 0
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content=MRSA越来越多了，是个骨髓炎都是MRSA, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/KQpJHrQFQnfIZOLovl0G6KWH8tNAI2p6HGEicwiaJXeaGSqPHGgfk45GxVRKth8dAR4nDhyThrORVlyYaGapZ6vA/0, createdBy=5ea82055533, createdName=披头士, createdTime=Sun May 07 16:05:33 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
2017-05-08 往日如昨

学习了谢谢分享

54 0
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content=MRSA越来越多了，是个骨髓炎都是MRSA, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/KQpJHrQFQnfIZOLovl0G6KWH8tNAI2p6HGEicwiaJXeaGSqPHGgfk45GxVRKth8dAR4nDhyThrORVlyYaGapZ6vA/0, createdBy=5ea82055533, createdName=披头士, createdTime=Sun May 07 16:05:33 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
2017-05-08 天涯183

非常好的文章，学习了，很受益

46 0
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content=MRSA越来越多了，是个骨髓炎都是MRSA, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/KQpJHrQFQnfIZOLovl0G6KWH8tNAI2p6HGEicwiaJXeaGSqPHGgfk45GxVRKth8dAR4nDhyThrORVlyYaGapZ6vA/0, createdBy=5ea82055533, createdName=披头士, createdTime=Sun May 07 16:05:33 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
2017-05-07 明月清辉

谢谢分享，学习了

54 0
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content=MRSA越来越多了，是个骨髓炎都是MRSA, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/KQpJHrQFQnfIZOLovl0G6KWH8tNAI2p6HGEicwiaJXeaGSqPHGgfk45GxVRKth8dAR4nDhyThrORVlyYaGapZ6vA/0, createdBy=5ea82055533, createdName=披头士, createdTime=Sun May 07 16:05:33 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
2017-05-07 1e145228m78(暂无匿称)

学习了，谢谢作者分享!

44 0
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content=MRSA越来越多了，是个骨髓炎都是MRSA, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/KQpJHrQFQnfIZOLovl0G6KWH8tNAI2p6HGEicwiaJXeaGSqPHGgfk45GxVRKth8dAR4nDhyThrORVlyYaGapZ6vA/0, createdBy=5ea82055533, createdName=披头士, createdTime=Sun May 07 16:05:33 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
2017-05-07 1dd8aa01m06(暂无匿称)

学习了很好的内容

21 0
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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sun May 07 17:37:52 CST 2017, time=2017-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195053, encodeId=0171195053f5, content=学习了很好的内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Sun May 07 16:22:59 CST 2017, time=2017-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195047, encodeId=024419504e44, content=MRSA越来越多了，是个骨髓炎都是MRSA, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/KQpJHrQFQnfIZOLovl0G6KWH8tNAI2p6HGEicwiaJXeaGSqPHGgfk45GxVRKth8dAR4nDhyThrORVlyYaGapZ6vA/0, createdBy=5ea82055533, createdName=披头士, createdTime=Sun May 07 16:05:33 CST 2017, time=2017-05-07, status=1, ipAttribution=)]
2017-05-07 披头士

MRSA越来越多了，是个骨髓炎都是MRSA

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