PICC置管导致医院感染暴发事件流行病学调查  

Nosocomial Infection Outbreak Associated with PICC: Its Epidemiological Investigation

作　　者：李静玫[1] 李海峰[1] 马萍[1] 冯海华[1] 李京宁[1] 

机构地区：[1]解放军202医院感染控制科,辽宁沈阳110003

出　　处：《中华医院感染学杂志》2010年第3期345-347,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查某医院肿瘤科经外周中心静脉导管(PICC)导致医院感染暴发的原因和危险因素,为控制医院感染提供参考依据。方法对肿瘤科病房发生PICC导管感染的所有患者进行现场流行病学调查并采样监测,细菌培养与鉴定按《全国临床检验操作规程》进行,药敏试验采用纸片扩散(K-B)法。结果使用PICC置管的9例患者中7例血液、导管或分泌物培养分离出肺炎克雷伯菌;水龙头、无菌镊子缸、部分工作人员手及其他物体表面亦有肺炎克雷伯菌生长;经采取有效控制措施,8例患者痊愈出院,1例死亡。结论该科室部分医务人员无菌观念淡漠、消毒隔离技术执行不严格、晚期肿瘤患者免疫功能低下和PICC置管时间较长,均是引起医院感染暴发的主要原因。OBJECTIVE To investigate the transmission process of nosocomial infection outbreak associated with peripherally inserted central catheter （PICC） at the department of oneology in a certain hospital, to confirm risk factors, to provide reference evidence to control the infection in hospital. METHODS The epidemiological investigation of all patients infected in wards at the department of oncology and samples was taken. Bacterial culture and identification were under takenaccording to NationalRoutine Practice for Clinical Exams. Antibiotic susceptibility test was performed by K-B method. RESULTS Blood or catheter culturing in 7 patients out of 9 cases were found Klebsiella pneumoniae. K. pneumoniae was also found on the surface of taps, sterile forceps urns, some staffs＇ hands, and other objects. Eight patients were cured after taking effective methods and one patient died. CONCLUSIONS The main reasons for the nosocomial infection outbreak may include some staff＇s indifference＇ to sterile process, loose execution of disinfections and isolation, advanced cancer patients＇ immunocompromising, and long-term existance of PICC.

关 键 词：PICC置管 肺炎克雷伯菌 医院感染 流行病学 

分 类 号：R181.32[医药卫生—流行病学]