Effect of PDCA cycle method on management of methicillin-resistant Staphylococcus aureus
- 管理学院－已发表论文 
目的研究PDCA循环法在耐甲氧西林金黄色葡萄球菌(MRSA)管理中的实施效果。方法回顾性分析2012年1月-2016年12月住院患者送检标本的细; 菌鉴定和药敏试验结果,Cox-Stuart趋势检验分析MRSA的检出率和耐药趋势。结果金黄色葡萄球菌中MRSA检出率为31.17%,经Cox-S; tuart趋势检验分析,检出率呈下降趋势;MRSA对利奈唑胺、替加环素、替考拉宁、万古霉素、呋喃妥因、磺胺甲噁唑/甲氧苄啶、莫西沙星的耐药率<3; 0%,对青霉素、头孢西丁、苯唑西林、红霉素的耐药率>75%;经CoX-Stuart趋势检验分析,MRSA对四环素、克林霉素、环丙沙星、庆大霉素、; 利福平、左氧氟沙星的耐药率呈下降趋势,而对头孢西丁、红霉素、苯唑西林、青霉素、莫西沙星、复方新诺明、呋喃妥因、万古霉素、利奈唑胺、替加环素、替考; 拉宁的耐药率无变化趋势。结论PDCA循环法在MRSA管理中的实施效果良好,使得MRSA检出率和对克林霉素等抗菌药物的耐药率呈下降趋势。OBJECTIVE To observe the effect of PDCA cycle method on management of; methicillin-resistant Staphylococcus aureus (MRSA). METHODS The patients; who were hospitalized from Jan 2012 to Dec 2016 were enrolled in the; study, the submitted specimens were cultured, the drug susceptibility; testing was performed for the isolated pathogens, and the isolation rate; of MRSA and drug resistance trend were analyzed by means of Cox-Stuart; trend test. RESULTS Among the S. aureus strains, the isolation rate of; MRSA was 31. 17%. The Cox-Stuart trend test indicated that the isolation; rate showed a downward trend. The drug resistance rates of the MRSA; strains to linezolid, tigecycline, vancomycin, nitrofurantoin,; trimethoprim-sulfamethoxazole and moxifloxacin were less than 30% ; the; drug resistance rates to penicillin, cefoxitin, oxacillin and; erythromycin were more than 75%. The Cox-Stuart trend test analysis; showed that the drug resistance rates of the MRSA strains to; tetracycline, clindamycin, ciprofloxacin, gentamycin, rifampicin and; levofloxacin were decreased, however, the drug resistance rates to; cefoxitin, erythromycin, oxacillin, penicillin, moxifloxacin,; trimethoprim-sulfamethoxazole, nitrofurantoin, vancomycin, linezolid,; tigecycline and teicoplanin did not change. CONCLUSION The PDCA cycle; method can achieve significant effect on the management of MRSA and; reduce the isolation rate of MRSA as well as the drug resistance rate to; the antibiotics like clindamycin.