手卫生在控制MRSA感染种的作用hand and MRSA.pptVIP

Transmission of Healthcare-Associated MRSA (HA-MRSA) Patients colonized or infected with MRSA are the major reservoir from which transmission occurs HA-MRSA is most often transmitted from patient to patient via the hands of healthcare workers (HCWs) who have transiently contaminated their hands Persistently colonized or infected HCWs can also be a source of transmission Contaminated environmental surfaces may also serve as source of MRSA transmission MRSA Hand Hygiene Topics How do HCWs contaminate their hands with MRSA? Does hand hygiene remove MRSA from hands? What evidence is there that hand hygiene contributes to control of MRSA? How can we improve hand hygiene practices? How Do HCWs Contaminate Their Handswith MRSA? Touching colonized or infected patients Touching contaminated environmental surfaces in the immediate vicinity of affected patients For HCWs who are persistently colonized with MRSA, touching their own nose or mucous membranes Hand Contamination Following Contact with Patients or Their Environment HCWs who entered MRSA patient rooms were enrolled in a prospective study After patient contact, cultures were performed One gloved hand was cultured first Both gloves were removed and hands were washed Second hand was cultured to assess efficacy of washing 17% of HCWs who touched the patient, patient’s clothes, or bed contaminated their gloves with MRSA Hand Contamination Following Contact with Patients or Their Environment 14% of HCWs who did not wear gloves contaminated their hands with MRSA HCWs who did not wear gloves were 5.2 times more likely to have MRSA on their hands AFTER handwashing than those who wore gloves (p = 0.3) Hand Contamination from Medical Items All 5 nurses who changed dressings of infected patients had MRSA on their hands All 5 personnel who handled specimen containers or medical equipment removed from patient rooms had MRSA on their hands 5 (42%) of the 12 nurses who had no d