新生儿重症监护病房肺炎克雷伯菌医院感染暴发事件的调查与防控  

Investigation and Prevention and Control of Hospital Infection Outbreaks of Klebsiella Pneumoniae in Neonatal Intensive Care Units

作　　者：徐文君[1] 吴岷岷 杨力[1] 张胜男[1] 尚前 XU Wen-jun;WU Min-min;YANG L;ZHANG Sheng mnan;SHANG Qian(Women's hospital of Nanjing Medical University/Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院/南京市妇幼保健院,南京市210004

出　　处：《现代医院管理》2024年第2期90-93,共4页Modern Hospital Management

摘　　要：目的调查一起在新生儿重症监护病房(NICU)发生的肺炎克雷伯菌(KP)医院感染暴发事件,评价控制措施实施效果,为医院感染防控提供依据。方法采用流行病学调查和环境卫生学监测方法对2020年6-8月在NICU检出KP的患者进行原因分析并采取控制措施。结果14例检出KP的患者中,9例医院感染,KP引发的医院感染例次率高于3-5月(P<0.05)。84份环境卫生学标本,2份标本检出KP。采取综合性与针对性控制措施后,复查未检出KP,9-11月医院感染例次率显著下降(P<0.05)。结论本次事件推测为外源性的KP定植于电热烧水器托盘,经由医务人员手或水杯等物品直接或间接接触传播。通过查找感染源,采取集束化、针对性干预策略,有效控制医院感染的蔓延。Objective:To investigate the nosocomial infection outbreak of Klebsiella pneumoniae(KP)in neonatal intensive care unit(NICU),evaluate the effect of control measures,and provide evidence for nosocomial infection prevention and control.Method:Epidemiological investigation and environmental health monitoring methods were used to analyze the causes of KP detected in NICU patients from June to August 2020,and control measures were taken.Result:Among the 14 patients with the detected Klebsiella pneumoniae,9 cases had nosocomial infection,and the rate of nosocomial infection caused by KP was higher than that in March to May(P<0.05).KP was detected in 2 of 84 environmental hygiene specimens.After taking comprehensive and targeted control measures,no KP was detected in reexamination,so the nosocomial infection rate decreased significantly from September to November(P<0.05).Conclusion:This incident is speculated to be caused by exogenous KP colonization on the electric water heater tray,which was directly or indirectly transmitted through contact with medical personnel's hands or water cups.By identifying the source of infection and adopting a bundled and targeted intervention strategies,the spread of hospital infections can be effectively controlled.

关 键 词：肺炎克雷伯菌 新生儿重症监护病房 医院感染 流行病学 控制措施 

分 类 号：R197[医药卫生—卫生事业管理]