ICU病房MDROs新感染患者周围环境物体表面污染情况调查及清洁消毒建议  

Investigation on environmental object surface contaminations of a newly infected patient with multidrugresistant organisms and suggestions of cleaning and disinfection in ICU

作　　者：冯丽萍[1] 杨华[1] 杨旭[1] 程曦[1] 陈莉[1] Feng Liping;Yang Hua;Yang Xu;Cheng Xi;Chen Li(Second Hospital,Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院,650101

出　　处：《国际医药卫生导报》2019年第12期1892-1897,共6页International Medicine and Health Guidance News

基　　金：云南省卫生科技计划项目(2016NS255).

摘　　要：目的 调查ICU病房新感染多重耐药菌患者周围环境物体表面相同耐药菌污染情况,探讨有效的清洁消毒措施和消毒范围,为加强多重耐药菌感染防控提供循证依据。方法 于2018年3月26日采集内科ICU病房新报1例多重耐药鲍曼不动杆菌感染患者及隔壁床患者周围56个物体表面进行细菌培养,检查相同药敏多重耐药鲍曼不动杆菌检出情况。结果 共53个物体表面和3个医护人员手采样进行细菌培养;新发感染患者周围53个物体表面检出多重耐药鲍曼不动杆菌物体表面28个,物体表面平均污染率为52.83%;其中,检测新发感染患者床单元周围物体表面20个,检出被污染表面17个,污染率85.00%;检测新发感染患者隔壁床单元周围物体表面采样18个,检出被污染表面6个,污染率33.33%;病房公共空间采样15个物体表面,检出被污染表面5个,污染率33.33%;医务人员手部3个采样均未检出细菌。结论 当ICU出现多重耐药菌新感染患者时,患者原住的病房相同药敏多重耐药菌污染情况严重,全病房环境包括感染患者、隔壁患者和公共空间的物体表面均需按多重耐药菌污染后要求加强环境物体表面清洁消毒。Objective To investigate the same multidrug-resistant contamination situation of environmental object surface of a newly infected patients with multidrug-resistant organisms(MDROs)in ICU ward,and to explore effective cleaning and disinfection approaches and provide some evidences for the prevention and control of MDROs.Methods 56 environmental object surfaces of one newly infected patient in MICU with multidrug-resistant acinetobacterbaumannii(MDR-Ab)and one patient next bed for bacteria culture on 26th March,2018 were collected to examine and analyze the same MDR-Abdrug sensitivity on object surfaces of MICU.Results A total of 56 samples were collected for bacteria culture;53 of which were collected from the surrounding object surfaces of the newly infected patient,and 3 from hands of medical staff.The number of surrounding object surfaces with MDR-Abdetected was 28 out of 53,and the average rate of surface contamination was 52.83%.Among them,20 surrounding object surfaces were collected from the bed unit of the newly infected patient,17 of which were contaminated and the rate was 85.00%;18 were collected from the next bed unit of the newly infected patient,6 of which were contaminated and the rate was 33.33%;15 were collected from the public space of the ward,5 of which were contaminated and the rate was 33.33%.No bacteria were detected from all the 3 samples from the hands of medical staff.Conclusion When the newly infected patients in ICU with MDROs was detected,the environmental object surface contamination in the original ward was so severe that the surface of the whole ICU ward,the newly infected patient,the patient next bed,and the public space should all be reinforced for cleaning and disinfection followed by MDROs prevention and control regulation.

关 键 词：ICU 多重耐药菌感染 新感染患者 物体表面污染 清洁消毒 

分 类 号：R472.1[医药卫生—护理学]