主動監測培養在臨床之應用及成效

Effect and Clinical Application of Active Surveillance Cultures

主動監測培養可以降低多重抗藥性微生物的流行，主要是針對加護單位，於病人入住加護單位時，先進行主動監測培養及隔離防護，直到培養結果確認為陰性，再解除隔離，會有較好的預防成效。當施行多重抗藥性微生物盛行率高的單位或每年減少2.9或4個醫療照護相關感染時，主動監測培養方具成本效益。醫療照護機構應定期監測手部衛生、隔離防護及環境清潔的執行情形。若在上述措施執行良好的情況下，仍無法控制多重抗藥性微生物的流行時，得配合主動監測培養，以發現潛在帶菌病人，採行隔離防護，以防止病原散播。

Active surveillance cultures have been used to control multidrug-resistant organisms (MDROs) in intensive care units among newly admitted patients. Initial isolation of all patients, with withdrawal of isolation if the results of surveillance cultures are negative, has been found to result in a significant reduction in the incidence rates of colonization of MRDOs. A screening program was found to be cost effective only when active surveillance cultures were used in a unit with high prevalence of MDROs or 2.9 infections were prevented per year. Healthcare institutions need to monitor compliance of hand hygiene, contact precaution, and regular environmental cleaning. Active surveillance cultures should not be used routinely unless the epidemiology of MDROs cannot be controlled by good adherence of aforementioned infection prevention measures to prevent the transmission of MDROs, by identifying MDROs carriage, or by implementing contact precautions.