重症监护病房鲍氏不动杆菌医院感染暴发及控制  

Outbreak and Control of Hospital Infection of Acinetobacter baumannii in ICU

作　　者：谢少清[1] 左改珍[1] 范恒梅[1] 王丽红[1] 张亮[1] 梅雪飞[1] 张莉莉[1] 荚恒敏[1] 

机构地区：[1]安徽省立医院感染管理科,安徽合肥230001

出　　处：《中华医院感染学杂志》2010年第12期1661-1663,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查重症监护病房(ICU)鲍氏不动杆菌医院感染暴发原因,探讨控制措施的有效性。方法对ICU7月1-29日12例下呼吸道鲍氏不动杆菌感染患者,进行危险因素调查及环境微生物监测、分子流行病学调查并实施预防控制。结果除病情危重、年龄大,气管插管或气管切开+机械通气等危险因素外,还存在ICU环境污染,在环境微生物监测中物体表面和手共采集标本73份,有16份标本中分离到鲍氏不动杆菌,有13株DNA(RAPD)基因分型为同一型,采取综合措施后,使ICU下呼吸道痰标本中鲍氏不动杆菌的检出率逐渐下降,从7月份的30.0%下降至12月份的12.0%。结论对ICU患者进行隔离,对病室环境及医疗器械特别是呼吸器具进行彻底消毒,优化护理流程,提高手卫生的依从性,是降低外源性感染、控制暴发流行的有效措施。OBJECTIVE To investigate the causes of ICU hospital Acinetobacter baumanni infection oatbreaks and evaluate the effectiveness of control measures. METHODS From July 1st to 29th, 12 ICU patients with A. baumanii lower respiratory tract infections underwent risk factors investigation and environmental microbial observation, as well as molecular epidemiology investigation and implementation of prevention and control. RESULTS In addition to such risk factors as critical condition, old age, endotracheal intubation and tracheostomy＋mechanical ventilation, and so on, environmental contamination remained in the ICU ward. From the collection of the environmental microbial investigation table and 73 hand samples, 16 samples of A. baurnannii were isolated, with 13 samples whose DNA （RAPD） genotypes were of the same type. After adopting the comprehensive measures, the detection of lower respiratory tract sputum ICU A. baumannii infection has declined from 30 %in July to 12 % 1 in Dec. CONCLUSIONS The isolation of ICU patients, the complete disinfection of the wardrs environment and medical equipment, especially the breathing machines, the optimization of the care process, and the improvement of hand hygiene compliance are effective measures to reduce the external infections and control the epidemical outbreaks.

关 键 词：重症监护病房 鲍氏不动杆菌 控制措施 手卫生 

分 类 号：R378[医药卫生—病原生物学]