Are meticillin-resistant Staphylococcus aureus bloodstream infection targets fair to those with other types of healthcare-associated infection or cost-effective?

摘要

Millar et a/.1 present the hypothesis that the Department of Health (DoH) target for the National Health Service (NHS) in England to reduce meticillin-resistant Staphyloccus aureus (MRSA) bloodstream infections (BSI) has had a detrimental effect on the control of other healthcare-associated infections (HCAIs). However, their argument is based on a premise that activities focused on reducing MRSA BSI are isolated entities, unique to the prevention and control of MRSA BSI and with no beneficial impact on other HCAIs. Furthermore, they present no evidence that this has in fact happened, whereas there is no doubt that the increased attention to HCAIs and the emphasis on infection prevention and control is having a significant beneficial effect on the delivery of safe healthcare in England. The lead author, Dr Millar, like many of us, has spent much of his professional life as a medical microbiologist in an environment where HCAI and the whole issue of infection prevention and control had a very low priority within the medical establishment and NHS management. Now, however, this issue is at the top of the agenda in all NHS bodies and Trust Boards and their Chief Executives are being held to account for delivering safe healthcare with a zero-tolerance approach to avoidable HCAIs