河南省某三甲医院重症监护病区多重耐药感染者住院环境病原菌监测  

Monitoring of pathogens in the surroundings of inpatients infected with multiple drug-resistant organisms in intensive care unit of a grade-Ⅲ,class A tertiary hospital in Henan

作　　者：刘彩红[1] 徐璐 闫苒[1] 李福琴[1] 郭俊爽 徐岷[1] 曾钰婷[1] 张娜[1] 苗旺[1] LIU Caihong;XU Lu;YAN Ran;LI Fuqin;GUO Junshuang;XU Min;ZENG Yuting;ZHANG Na;MIAO Wang(Department of Nosocomial Infection Management,the First Affiliated Hospital of Zhengzhou University;Department of Microbiology,Henan General Children's Hospital;Neurological intensive care unit,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450052,China)

机构地区：[1]郑州大学第一附属医院医院感染管理科 [2]河南省儿童医院微生物室 [3]郑州大学第一附属医院神经重症病区,河南郑州450052

出　　处：《河南预防医学杂志》2022年第7期492-495,共4页Henan Journal of Preventive Medicine

基　　金：中国老年医学学会感染防控研究基金(GRYJ-LRK2018019)。

摘　　要：目的 调查重症监护病区(intensive care unit,ICU)多重耐药菌(multidrug-resistant organisms,MDRO)感染者住院环境病原菌污染情况,为ICU MDRO医院感染防控提供依据。方法 2020年4-6月对某三级甲等医院6个ICU MDRO感染者住院环境病原菌进行随机采样,检测病原菌菌落数和MDRO致病菌。结果 6个ICU MDRO感染者住院环境178份标本中,92份(51.69%)菌落数超标;51份(28.65%)检出碳青霉烯耐药革兰阴性杆菌(carbapenem-resistant organism,CRO),其中菌落数超标和检出CRO较高的为MDRO感染者隔离病室内洗手水池(分别为87.50%和75.00%)、患者物品小桌(分别为73.53%和29.41%)、ICU其他非隔离病室洗手水池(分别为65.79%和60.53%)差异有统计学意义(P<校正后的显著性水平0.003)。178份标本中,6份(3.37%)菌落数不超标而有CRO生长,70份(26.40%)菌落数超标而无CRO生长,45份(25.28%)菌落数超标并有CRO生长;菌落计数是否超标和培养出CRO之间有关联(列联系数=0.421)。结论 ICU MDRO感染者住院环境中,隔离病室和非隔离病室内的洗手水池、患者物品小桌病原菌污染率较高,提示应加强ICU MDRO感染者住院环境的清洁消毒工作,定期开展病原菌监测。Objective To investigate the pathogen contamination in the surroundings of inpatients infected with multidrug-resistant organisms(MDRO) in intensive care unit(ICU), so as to provide evidence for the management of hospital infection of MDRO in ICU. Methods A random sampling was conducted for detecting microbial colonies and MDRO in the surroundings of inpatients infected with MDROs in 6 ICUs in a grade-A tertiary hospital in Henan from April to June 2020. Results In the six ICUs,178 samples were collected from the surroundings of inpatients infected with MDROs. Of them, 92(51.69%) had exceedingstandard colony count, and 51(28.65%) were carbapenem-resistant gram-negative bacilli(CRO). The monitoring sites with exceeding standard of bacteria colonies and high detection rate of CROs were hand-washing sinks in the isolation room of patients with MDROs infection(87.50% and 75.00%, respectively), tables of patients(73.53% and 29.41%, respectively), and handwashing sinks in other non-isolation wards of ICU(65.79% and 60.53%, respectively). The differences were statistically signifi-cant(P value was less than the adjusted significant level of 0.00333). Of the 178 samples, 6(3.37%) had CRO growth without exceeding the standard of colony count, 70(26.40%) had exceeding-standard colony count without CRO growth, and 45(25.28%)had exceeding-standard colony count and CRO growth. There was a correlation between whether the colony count exceeded the standard and whether the CRO was cultured(contingency coefficient = 0.421). Conclusion The contamination rate of pathogen in the surroundings of inpatients infected with MDROs in ICU is high, especially the hand-washing sinks in both the isolation wards and non-isolation wards, and tables of patients. The cleaning and disinfection of the inpatient surroundings should be strengthened, and microbial surveillance should be carried out regularly.

关 键 词：重症监护病区 多重耐药菌 住院环境 污染 医院感染管理 

分 类 号：R378[医药卫生—病原生物学]