多药耐药鲍氏不动杆菌医院感染暴发事件调查与干预  

Outbreak and control of multidrug- resistant Acinetobacter baumannii infections

作　　者：张艳霞[1] 阿依提拉.卡德尔 杨环[1] 姚新宝[1] 苏梅[1] 

机构地区：[1]新疆维吾尔自治区人民医院医院感染管理科,乌鲁木齐830001

出　　处：《新疆医学》2017年第4期394-396,共3页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区人民医院院内科研项目(20140117)

摘　　要：目的了解外科重症监护病房(SICU)多药耐药鲍氏不动杆菌院内暴发的流行病学资料,探讨医院感染暴发的危险因素,为有效预防与控制感染暴发流行提供理论依据。方法采用回顾性调查的方法,对2015年5月4日-12日SICU发生的7例多药耐药鲍氏不动杆菌感染病例进行调查分析。结果 2015年5月4日-12日SICU33例住院患者中7例检出多药耐药鲍氏不动杆菌,罹患率为21.21%;感染部位为下呼吸道感染6例(占85.71%),血流感染1例(占14.29%);7株鲍氏不动杆菌对抗菌药物的耐药谱基本一致;对多药耐药鲍氏不动杆菌感染患者进行集中隔离、加强医务人员无菌操作流程、手卫生以及加强环境清洁与物品消毒管理等,有效控制了感染的发生。结论隔离措施不规范,侵入性操作多,医务人员手卫生意识差、环境消毒落实不到位是多药耐药鲍氏不动杆菌院内暴发流行的重要原因,多部门协作采取综合性干预措施,可以有效预防与控制医院感染暴发流行的发生。Objective To understand the epidemiological data of muhidrug-resistant Acinetobacter baumannii in surgical intensive care unit （SICU） , and to investigate the hospital infection risk factors for the occurrence of aggregation, and to provide a theoretical basis for effective prevention and control of hospital infection outbreaks. Methods A retrospective investigation was carried out to investigate the infection of 7 cases of multidrug-resistant Acinetobacter baumannii in SICU from May 4th 2015 to May 12th 2015. Results From May 4th 2015 to May 12th 2015 , there were 7 patients among 33 patients in SICU being detected to have multirug-resistant Acinetobacter baumannii with the infection rate of 21.21% ; Infection site was lower respiratory tract in 6 cases accounting for 85.71%. Bacteremia was found in 1 cases which accounted for 14.29% ; Acinetobacter baumannii specimens were mainly from sputum and blood ; 7 strains of Ban＇s real resistant bacillus speetra were similar close to penicillins, quinolones and cephalosporins..Patients who got the multi drug resistant Acinetobacter infection were isolated, and the medical personnel aseptic operation process were strengthened. Environmental cleaning and disinfection management were also strengthened. All those measures controlled the ocurrence of infection effectively. Conclusion Important zasons for multi drug resistant Acinetobacter bacteria outbreaks were mainly nonstandard isolation measures, many invasive operation, and poor hand hygiene of medical staff. Different sectors should collaborate to take comprehensive intervention measures in order to prevent and control effectively the occurrence of hospital infection.

关 键 词：多药耐药 鲍氏不动杆菌 暴发流行 感染控制 

分 类 号：R378[医药卫生—病原生物学]