疑似多重耐药鲍曼不动杆菌ICU感染暴发原因分析  

Analysis of causes of infection outbreak of suspected multidrug-resistant Acinetobacter baumannii in ICU

作　　者：舒红梅[1] 江华[1] 曹霖[1] 蔡霞[1] 和国珍 SHU Hongmei;JIANG Hua;CAO Lin;CAI Xia;HE Guozhen(Suining Central Hospital,Suining 629000 Sichuan,China)

机构地区：[1]遂宁市中心医院,四川遂宁629000

出　　处：《中国民康医学》2021年第18期1-3,6,共4页Medical Journal of Chinese People’s Health

基　　金：四川省卫生和计划生育委员会科研课题(18PJ451)。

摘　　要：目的:分析疑似多重耐药鲍曼不动杆菌重症监护室(ICU)感染暴发的原因。方法:回顾性分析2018年1月15日至2月24日该院ICU收治的9例多重耐药鲍曼不动杆菌感染患者的临床资料,观察感染时间分布、床位分布、痰标本分离出鲍曼不动杆菌药敏试验结果、ICU环境卫生学检测结果和预后。结果:9例多重耐药鲍曼不动杆菌感染患者发病时间为2018年1月15日至2月24日,相对集中,床位存在重叠或相邻;9例患者痰标本分离出鲍曼不动杆菌药敏试验耐药谱基本一致;51份环境样本分离出鲍曼不动杆菌,分布在输液泵、监护仪、签字笔和床栏等16个部位;51份环境样本药敏试验耐药谱与病例痰标本培养分离的耐药菌株耐药谱基本一致;6例患者好转转出ICU,3例患者因治疗效果差自行出院。结论:9例耐药鲍曼不动杆菌感染为疑似医院感染暴发,环境消毒不彻底及工作人员手卫生不达标是此次医院感染暴发的主要原因。Objective:To analyze causes of infection outbreak of suspected multidrug-resistant Acinetobacter baumannii in intensive care unit(ICU).Methods:The clinical data of 9 patients with multidrug-resistant Acinetobacter baumannii infection admitted to the ICU of Suining Central Hospital from January 15 to February 24,2018 were retrospectively analyzed.The infection time distribution,the bed distribution,the drug sensitivity test results of Acinetobacter baumannii isolated from the sputum specimens,the ICU environmental hygiene test results and the prognosis were observed.Results:The onset time of the 9 patients with multi-drug resistant Acinetobacter baumannii infection was from January 15 to February 24,2018,which was relatively concentrated.The beds were overlapped or adjacent.The drug sensitivity test results of Acinetobacter baumannii isolated from the sputum specimens of the 9 patients showed that the drug resistance spectrums were basically consistent.Acinetobacter baumannii was also isolated from 51 environmental samples,which were distributed in 16 locations including infusion pumps,monitors,signature pens,bed rails and the like.Further,the drug susceptibility test showed that the drug resistance spectrum of 51 environmental samples were consistent with those from the sputum samples.6 patients were recovered and transferred out of ICU,while 3 patients were discharged automatically due to poor treatment effects.Conclusions:For the 9 patients with suspected drug-resistant Acinetobacter baumannii nosocomial infection outbreak,the incomplete environmental disinfection and the inadequate hand hygiene of the staff are the main reasons.

关 键 词：ICU 鲍曼不动杆菌 多重耐药 感染暴发 痰标本 药敏试验 

分 类 号：R181.3[医药卫生—流行病学]