ICU耐碳青霉烯类鲍氏不动杆菌医院感染监测与控制  

Monitoring and control of nosocomial infection caused by carbapenem-resistant acinetobactor baumannii in ICU

作　　者：周东升[1] 鲍凤[2] 林荣[3] 沈志君[3] 

机构地区：[1]铜陵市人民医院检验科,安徽铜陵244000 [2]铜陵市人民医院门诊部,安徽铜陵244000 [3]铜陵市人民医院感染管理科,安徽铜陵244000

出　　处：《中华医院感染学杂志》2011年第6期1082-1085,共4页Chinese Journal of Nosocomiology

基　　金：安徽省铜陵市卫生局科研课题资助项目(卫科研[2009]10)

摘　　要：目的了解医院ICU耐碳青霉烯类鲍氏不动杆菌医院感染状况,查找传染源及传播途径,为及时采取有效的预防控制措施提供依据。方法对ICU 2008年7-12月发生的耐碳青霉烯类鲍氏不动杆菌医院感染进行流行病学回顾性调查;对其环境进行大面积卫生学监测,并用肠杆菌属基因间保守重复序列聚合酶链反应(ERIC-PCR)进行耐碳青霉烯类鲍氏不动杆菌同源性分析。结果 2008年7-12月,在ICU共23例患者发生了耐碳青霉烯类鲍氏不动杆菌医院感染;环境卫生学监测共采得标本86份,其中在门把手、监护仪、听诊器、医护人员手、呼吸机及患者床头用品等54处检出耐碳青霉烯类鲍氏不动杆菌,污染率达62.8%;DNA图谱显示23株菌均为同一克隆菌株。结论医院ICU有耐碳青霉烯类鲍氏不动杆菌同一克隆株的暴发流行,环境污染严重可能是暴发流行的主要原因;大力加强ICU耐碳青霉烯类鲍氏不动杆菌医院感染管理工作已刻不容缓。OBJECTIVE To investigate the status of the nosocomial infection caused by carbapenem-cesistant Acinetobactor baumannii in ICU,to search for infection sources and route of transmission,and to provide evidence for the effective control measures.METHODS The retrospective analysis of the nosocomial infection caused by carbapenem-resistant A.baumannii strains in ICU between Jul 2008 and Dec 2008 was conducted,and the environmental health monitoring was executed.ERIC-PCR was carried out for the homology of the isolates.RESULTS Totally 23 patients appeared the nosocomial infection caused by carbapenem-resistant A.baumannii in ICU during Jul 2008 to Dec 2008.In all 86 samples,54 carbapenem-resistant A.baumannii strains were isolated from door handle,monitor,stethoscopes,the hands of medical personnel,respirator,and household items of patients.The contamination rate was 62.8%（54/86）.DNA homologous analysis indicated that 23 strains were the identical clone strains.CONCLUSIONS The outbreak and prevalenceof the same clone carbapenem-resistant A.baumannii strain in ICU and environmental pollution may be the main reasons for the nosocomial outbreak.That is pressing to strengthen the management of nosocomial infection caused by carbapenem-resistant A.baumannii.

关 键 词：重症监护病房 鲍氏不动杆菌 碳青霉烯类 医院感染 流行病学调查 

分 类 号：R378[医药卫生—病原生物学]