一起关节镜术后关节腔隙感染聚集事件的调查与控制  

Investigation and Control of a Joint Space Infection Cluster Event After Arthroscopy

作　　者：张燕 韩晴 许盼盼 Zhang Yan;Han Qing;Xu Pan-pan(Xuzhou Renci Hospital,Xuzhou 241004,Jiangsu Province,China)

机构地区：[1]徐州仁慈医院,江苏徐州241004

出　　处：《中国社区医师》2023年第1期148-150,共3页Chinese Community Doctors

摘　　要：目的:分析关节科一起黏质沙雷菌导致的关节镜术后膝关节腔隙感染聚集事件的发生原因,为医院感染预防与控制提供参考。方法:选取2020年10月某医院关节科2例关节镜术后关节腔隙感染患者为研究对象,进行流行病学调查分析,通过查阅病历资料、现场访谈、采集相关环境卫生学微生物样本、回顾性调查等方法,筛查医院感染相关危险因素。结果:2020年10月,该院关节科出现2例患者膝关节镜术后关节腔隙感染,关节液检出黏质沙雷菌靶向脱氧核糖核酸(DNA)测序鉴定与腔镜清洗工作站酶洗液中检出的黏质沙雷菌高度一致,认定此次事件为酶液污染引起的医院感染聚集事件。结论:硬式内镜清洗工作站清洁消毒不到位,酶液污染等是造成此次感染聚集事件的主要因素,积极开展流行病学调查并采取综合感控措施,能够有效预防医院感染事件的发生。Objective:To analyze the causes of a joint space infection cluster event caused by Serratia marcescens after arthros-copy in the joint department,and provide a reference for the prevention and control of nosocomial infection.Methods:Two patientswith joint space infection after arthroscopy in the joint department of a hospital in October 2020 were selected as the study sub-jects for epidemiological investigation and analysis.The risk factors of nosocomial nfection were screened through consulting medi-cal records,field interview,collection of relevant environmental health microbial samples and retrospective investigation.Results:In October 2020,two patients had joint space infection after arthroscopy in the joint department of this hospital.The targeted de-oxyribonucleic acid(DNA)sequencing identification of Serratia marcescens detected in joint fluid was highly consistent with Ser-ratia marcescens detected in the enzyme lotion of the endoscopic cleaning workstation,and this event was identified as a clusterevent of nosocomial infection caused by enzyme fluid contamination.Conclusion:The cleaning and disinfection in rigid endo-scopic cleaning workstation are not performed in place,and the enzyme fluid contamination is the main factors causing this infec-tion cluster event.Active epidemiological investigation and comprehensive infection control measures can effectively prevent theoccurrence of nosocomial infection events.

关 键 词：关节镜手术 黏质沙雷菌 医院感染聚集事件 生物膜 流行病学调查 

分 类 号：R687.4[医药卫生—骨科学] R197.323[医药卫生—外科学]