神经内科ICU耐碳青霉烯鲍氏不动杆菌感染调查与控制

发布时间：2018-05-03 10:45

本文选题：耐碳青霉烯鲍氏不动杆菌 + 暴发　；参考：《中华医院感染学杂志》2017年18期

【摘要】：目的对神经内科ICU患者耐碳青霉烯鲍氏不动杆菌感染事件进行调查与控制,为临床多药耐药菌预防控制提供参考。方法对2017年2月27日-2017年3月10日神经内科ICU 4例耐碳青霉烯鲍氏不动杆菌感染患者进行流行病学调查,采用环境生物学监测方法采集标本124份,其中空气21份,物体表面87份,医务人员手部6份、鼻腔6份、工作服4份,查找环境中的鲍氏不动杆菌,Eric(肠杆菌基因间重复共有序列)-PCR和多位点序列分型(MLST)分析患者分离的菌株与环境中菌株的同源性。结果 Eric-PCR和MLST结果显示4名患者的痰液标本中检出2种基因型鲍氏不动杆菌,分别为ST92型和ST75型,其中1床和12床患者临床菌株具有同源性,09床和19床患者临床菌株具有同源性;6份物体表面标本检出鲍氏不动杆菌,分别为鼻饲碗、床沿、护理人员工作服,其中12床鼻饲碗,09、19床床沿,护理人员工作服上检出的鲍氏不动杆菌与12床患者痰液标本中的鲍氏不动杆菌属于同一基因型。结论环境物体表面的消毒、手卫生和隔离措施的缺失是此次多药耐药菌传播的环节,在多药耐药菌患者的诊疗过程中应当重视消毒隔离措施的执行。
[Abstract]:Objective to investigate and control the infection of acinetobacter baumannii in patients with ICU in neurology department, and to provide reference for the prevention and control of multidrug resistant bacteria. Methods from February 27, 2017 to March 10, 2017, four patients with Acinetobacter baumannii infection in Department of Neurology, Department of Neurology, were investigated by epidemiology. 124 samples were collected by environmental biological monitoring method, among which 21 were airborne. 87 surfaces, 6 hands, 6 nasal passages, 4 overalls, To find Acinetobacter baumannii (Acinetobacter baumannii) in the environment (Enterobacter baumannii repeat common sequence-PCR and multilocus sequence typing) to analyze the homology between the strains isolated from patients and the strains in the environment. Results the results of Eric-PCR and MLST showed that two genotypes of Acinetobacter baumannii were found in sputum samples of 4 patients. They were ST92 type and ST75 type respectively. Acinetobacter baumannii was found in 1 bed and 12 beds of clinical strains in 9 beds and 19 beds in 6 samples of object surface, which were nasal feeding bowls, bedsides, and nursing staff overalls, respectively. Acinetobacter baumannii detected on the working clothes of nursing staff and Acinetobacter baumannii in sputum of 12 beds belonged to the same genotype. Conclusion Disinfection, hand hygiene and lack of isolation measures on the surface of environmental objects are the links of the transmission of multidrug resistant bacteria. The execution of disinfection and isolation measures should be paid more attention to in the diagnosis and treatment of patients with multidrug resistance bacteria.
【作者单位】：南昌大学第一附属医院医院感染管理科;
【基金】：江西省科技厅重点基金资助项目(20152ACG70015)
【分类号】：R516

【相似文献】