| Summary: | 碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 99 === Methicilline-Resistant Staphylococcus aureus (MRSA) is a major pathogen causing health care-associated infection, and prevalence of MRSA is increasing in these years. Thus, the purpose of this study was exploring the effect of using active surveillance to MRSA colonization. Collected all clinical evidences of colonization of MRSA, and explore the influence of using active surveillance to MRSA colonization. The result of study will be the evaluation and reference of health care-associated infection of hospital.
Method of study was observational study. Population was from the infection ward and intensive care units of central hospital in Taipei. Sample of study recruited 182 participants who were in intensive unit and in infection ward for 24 hours, and collection the participants’ samples from nose and beside environments every Monday and Thursday per week during thirty of March, 2010 to thirty-one of August, 2010. Data analysis used SPSS 13.0, and logistic regression explored risk factor of MRSA colonization.
Result of study indicated that 97samples of participants’ noses MRSA culture(53.3%) and 13 samples of environment MRSA culture(7.1%) were positive during the first 24 hours in hospital. In the term of inpatient (excluded the positive samples of first 24 hours), positive nose culture was 50 participants(27.4%) and 35 samples of environment culture(19.2%) was positive in the inpatient; 9.2±14.8 days made nose culture from negative to positive and 11.4±10.2 days made environment culture from negative to positive. There was found a significant different of high risk factor influenced MRSA colonization becoming from negative to positive that were including: nasal gastric tube, steriod therapy and central venous catheter (p＜.05) by univariate. Moreover, result of logistic regression showed the patients who had bedsore result in MRSA colonization were 2.68 times (95%CI1.02-7.05, p=.046), taking steroid therapy result in MRSA colonization were 2.81 time (95%CI1.20-6.61, p=.018), days of staying in hospital is 1.06 times (95%CI1.01-1.02, p=.015)
Active surveillance could early find out MRSA colonization and focused on the high risk group that is including bedsore, steriod therapy, and long term staying in hospital. Result could be the reference of clinical. Increasing the admission assessment of high risk patents, to prevent and reduce MRSA of disseminating and cluster infection. and reducing MRSA outbreak happened.
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