摘要
目的分析重症监护病房(ICU)多重耐药鲍曼不动杆菌(AB)医院感染暴发流行的流行病学特征,为医院感染预防与控制提供依据。方法采用流行病学调查和环境卫生学监测的方法调查2015年4月1日—26日入住某院ICU后发生肺部感染的患者,分析各种危险因素并采取相应的预防控制措施。结果先后共发生15例泛耐药AB医院获得性下呼吸道感染。15例患者共分离AB15株。1、3、4、5号患者检出AB药敏结果相同;6、7、8、9号患者检出AB药敏结果相同;10、11号患者检出AB药敏结果相同;时间均相对集中。共采集43份环境表面和医务人员手标本,床头柜AB检出率为100.00%(1/1),监护仪按钮为75.00%(6/8)、医务人员手为66.67%(4/6),治疗桌、输液泵按钮、医生鼻拭子均未检出AB。至2015年5月下旬综合ICU内未再出现类似新发病例。结论此次AB医院感染可能通过ICU环境表面和医务人员手播散,患者检出的AB呈广泛耐药性,积极治疗患者和采取严格的消毒隔离措施,可有效控制进一步流行。
ObjectiveTo analyze the epidemiological characteristics of a healthcareassociated infection（HAI） outbreak due to multidrugresistant Acinetobacter baumannii （AB） in an intensive care unit（ICU）, and provide basis for the prevention and control of HAI. MethodsEpidemiological investigation and environmental hygiene monitoring methods were adopted to investigate patients who had pulmonary infection after they were admitted to the ICU of a hospital in April 126, 2015, risk factors were analyzed and corresponding preventive control measures were taken.Results A total of 15 cases of extensively drugresistant AB（XDRAB） healthcareassociated lower respiratory tract infection occurred. 15 strains of AB were isolated from 15 patients. No. 1, 3, 4, 5, No. 6, 7, 8, 9, and No. 10, 11 patients were detected AB with the same antimicrobial susceptibility testing results respectively; occurrence time of infection was relatively centralized. A total of 43 specimens from environmental surface and hands of health care workers（HCWs） were collected, detection rates of AB from bedside cabinet, monitor button, and hands of HCWs were 100.00%（1/1）, 75.00%（6/8）, and 66.67%（4/6）respectively. AB were not detected from specimens of treatment table, infusion pump button, and doctors’ nasal swabs. By late May 2015, there were no new such cases in ICU. ConclusionThis AB HAI may be spread through environmental surface and hands of HCWs in ICU, AB isolated from patients is extensively antimicrobial resistant, active treatment of patients and strict disinfection and isolation measures can effectively control further prevalence.
出处
《中国感染控制杂志》
CAS
北大核心
2017年第6期536-539,共4页
Chinese Journal of Infection Control
关键词
重症监护病房
ICU
鲍曼不动杆菌
泛耐药
医院感染
暴发
intensive care unit
ICU
Acinetobacter baumannii
extensively drug resistance
healthcare-associated infection
outbreak
