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Survey of policy for MRSA screening in English cataract surgical units and changes to practice after updated National guidelines

机译:更新英国国家白内障手术室MRSA筛查政策的政策调查和实践变更

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Background National guidelines on MRSA (methicillin-resistant Staphylococcus aureus ) screening policy in England have changed on a number of occasions, but there is limited data on its influence at a local level. The aim of this study was to determine if changes in National policy influenced preoperative screening of cataract patients for MRSA. Methods A structured telephone survey was conducted on all 133 ophthalmology units in England in 2004 and again in 2007 for the initial responders, after a change in national policy. Results A total of 74 units (56%) responded in 2004 and 71 units (96% of initial respondents) in 2007. In 2004, 57% of units screened for MRSA. They screened groups at high risk of carriage, including patients with previous MRSA (93%) and patients from Nursing homes (21%). Swab sites included the nose (100%), eyes (31%) and perineum (62%). In 2007, there was no significant change in the number of units that screened for MRSA (57% vs 66%; p?=?0.118; McNemar test). However, more units screened for MRSA in patients from nursing/residential homes (21% vs 51%; p =?0.004, McNemar test), and in patients who had recent admission to hospital (12% vs 36%; p =?0.003). In the second survey, 3 units (6%) now screened patients who were close relatives of MRSA carriers. Conclusion This survey has highlighted inconsistences in MRSA screening practice of day-case cataract surgery patients across England after 2 major national policy changes. A change in DoH policy only led to more units screening patients for MRSA from high risk groups.
机译:背景技术在英国,有关MRSA(耐甲氧西林金黄色葡萄球菌)筛查政策的国家指南在许多情况下已发生变化,但有关其在地方一级的影响的数据有限。这项研究的目的是确定国家政策的变化是否影响对白内障患者进行MRSA的术前筛查。方法2004年和2007年,在国家政策变更后,对英格兰的133个眼科单位进行了结构化电话调查,以调查最初的响应者。结果2004年共有74个单位(占56%)做出响应,2007年共有71个单位(占最初受访者的96%)做出响应。2004年,有57%的单位对MRSA进行了筛选。他们筛选了高携带风险的人群,包括先前有MRSA的患者(93%)和来自疗养院的患者(21%)。拭子部位包括鼻子(100%),眼睛(31%)和会阴(62%)。 2007年,筛查MRSA的单位数量没有显着变化(57%比66%; p?=?0.118; McNemar测试)。但是,从疗养院/住所患者中筛查MRSA的单位更多(21%vs 51%; p = 0.004,McNemar测试),以及最近入院的患者(12%vs 36%; p = 0.003)。 )。在第二项调查中,现在有3个单位(6%)筛选了MRSA携带者的近亲患者。结论该调查突出显示了在两次重大国家政策变更后,英格兰全日白内障手术患者的MRSA筛查实践仍存在不足。卫生部政策的变化仅导致更多单位从高风险人群中筛查患者的MRSA。

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