적극적 감염 관리를 통한 신생아 중환자실내의 MRSA 근절 효과 : 격리 프로그램 및 Chlorhexidine 사용

초록

Purpose : The increasing incidence and mortality of Methicillin-resistant Staphylococcus aureus (MRSA)colonization or blood-stream infection is an important problem in neonatal intensive care unit (NICU). The aims of this study are to evaluate the effective eradication of MRSA through the aggressive isolation program with or without the use of 2% chlorhexidine-gluconate (CHG) and to investigate significant risk factors of MRSA colonization in NICU. Methods : This study is a retrospective collected data among 414 neonates admitted to a NICU from June 1,2007, through October 31, 2009. We divided the groups into 3 periods according to isolation program or the use of 2% CHG. Results : The aggressive isolation program decreased the incidence of MRSA colonization and the additional use of 2% CHG has reduced much more the incidence of MRSA colonization and bacteremia. Days of hospitalization, use of central line, days of using central line, presence of respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD), isolation program, and isolation program + use of CHG were significant factors associated with MRSA colonization or bacteremia in univariate logistic regression analysis. Days of using central line and isolation program + use of CHG were significant after in multivariate logistic regression analysis. Conclusion : Hand hygiene, active MRSA surveillance culture, isolation, contact isolation, nursing/doctor cohorts and the use of 2% CHG as skin sterilizer were effective in eradicating to MRSA. The effort of shortening the days of using central line is also necessary.

키워드