鲍曼不动杆菌医院感染患者相关环境污染情况调查  

Investigation on environmental pollutions related to nosocomial infection of Acinetobacter baumannii

作　　者：钱惠芬[1] 樊飞[1] 刘芳[1] 徐兰[1] 施爱萍[1] 施菊萍[1] QIAN Hui-fen;FAN Fei;LIU Fang;XU Lan;SHI Ai-ping;SHI Ju-ping(Zhangjiagang Center for Disease Control and Prevention,Jiangsu 215600,China)

机构地区：[1]张家港市疾病预防控制中心,江苏215600

出　　处：《医学动物防制》2022年第7期703-707,共5页Journal of Medical Pest Control

基　　金：江苏省科技厅——疫苗流通全程追溯科技示范(BE2017678)。

摘　　要：目的调查鲍曼不动杆菌医院感染患者的相关环境污染状况,为有效预防和控制医院感染提供依据。方法按照《江苏省医院ICU鲍曼不动杆菌新发医院感染监测方案》要求,对重症监护病房(ICU)、神经外科和肿瘤中心病房7例感染患者相关环境物体表面鲍曼不动杆菌在确诊后及确诊1个月后分别采样并检测。结果共采集样本212份,检出鲍曼不动杆菌70株,检出率为33.02%,其中确诊后及确诊1个月后的检出率分别为29.46%(38/129)、38.55%(32/83),差异无统计学意义(χ^(2)=1.890,P>0.05)。不同病房的检出率分别为ICU 20.20%、神经外科48.72%、肿瘤中心34.29%,差异有统计学意义(χ^(2)=16.071,P<0.01)。不同采样范围的检出率分别为直接接触区23.08%、较少接触区39.13%、不接触区27.94%、消毒工具55.00%、手26.19%,差异有统计学意义(χ^(2)=12.548,P<0.05)。70株鲍曼不动杆菌菌株对氨苄西林、头孢唑啉、头孢替坦、氨曲南、呋喃妥因均耐药。结论医院应采取强化清洁消毒、提高手卫生、合理使用抗菌药物等有效干预措施,以减少医院感染的发生。Objective To investigate the environmental pollutions related to nosocomial infection of patients with Acinetobacter baumannii,and provide the evidence for effective prevention and control of nosocomial infection.Methods Acinetobacter baumannii was collected from related environmental object surfaces of 7 infected patients in intensive care unit(ICU),neurosurgery department and tumor central ward respectively after diagnosis and one month after diagnosis in accordance with the requirements of the Surveillance Plan for New Nosocomial Infection of Acinetobacter baumannii in ICU of Hospitals in Jiangsu.Results A total of 212 samples were collected,70 samples were detected to have Acinetobacter baumannii with the detection rate of 33.02%,the detection rate after diagnosis and one month after diagnosis was 29.46%(38/129)and 38.55%(32/83),respectively,and the difference wasn′t statistically significant(χ^(2)=1.890,P>0.05).The detection rate for different wards was 20.20%for ICU,48.72%for neurosurgery department ward and 34.29%for tumor central ward,respectively,and the difference was statistically significant(χ^(2)=16.071,P<0.01).The detection rate for different sampling areas involved 23.08%for the direct contact area,39.13%for the less contact area,27.94%for the non-contact area,55.00%for disinfect tools and 26.19%for hand hygiene,respectively,the difference was statistically significant(χ^(2)=12.548,P<0.05).Totally 70 strains of Acinetobacter baumannii were found to be resistant to ampicillin,cefazolin,cefotetan,aztreonam and furantoin.Conclusion The hospitals shall take effective intervention measures including intensified cleaning and disinfection and improved hand hygiene,appropriately apply antibacterial agents to reduce the incidence of nosocomial infections.

关 键 词：医院感染 鲍曼不动杆菌 环境 调查 多重耐药 消毒 手卫生 

分 类 号：R378[医药卫生—病原生物学]