一起水污染引起的新生儿铜绿假单胞菌感染暴发调查  

An outbreak of neonatal Pseudomonas aeruginosa infection caused by water contamination

作　　者：廖丹 韦艳妮 廖桂姨[2] 梁文婷[2] 马张杰[2] 梁莹 LIAO Dan;WEI Yanni;LIAO Guiyi;LIANG Wenting;MA Zhangjie;LIANG Ying(Department of Microbiology,School of Basic Medical Sciences,Guangxi Medical University,Nanning 530021,China;Department of Healthcare-associated Infection Management,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China)

机构地区：[1]广西医科大学基础医学院微生物学教研室,广西南宁530021 [2]广西壮族自治区妇幼保健院医院感染管理科,广西南宁530000

出　　处：《中国感染控制杂志》2025年第4期551-556,共6页Chinese Journal of Infection Control

摘　　要：目的分析某医疗机构新生儿铜绿假单胞菌感染暴发事件发生原因及干预措施的效果。方法对2024年5月26日—6月10日该医疗机构新生儿重症监护病房(NICU)中5例铜绿假单胞菌感染新生儿进行流行病学调查,对可能污染的环境进行采样,推断铜绿假单胞菌在NICU传播的原因,同时采取感染控制措施,并持续观察控制措施的效果。结果5例感染新生儿中,下呼吸道感染3例,下呼吸道合并血流感染2例;检出耐药谱一致的铜绿假单胞菌7株;感染新生儿为同一病室,具有空间和时间聚集性。通过环境卫生学监测,从NICU洗手池及水源相关的环境中(吸引连接管、床旁隔离衣)分离出与新生儿感染耐药谱一致的铜绿假单胞菌。通过改进洗手池消毒方式、强化接触隔离措施等,感染得以控制,环境中未再检测出铜绿假单胞菌。结论本次NICU新生儿医院感染暴发事件推断为病房洗手池遭到铜绿假单胞菌污染,进而污染吸引连接管,通过吸痰操作导致的新生儿感染蔓延。医院感染监控专职人员要充分了解暴发感染病原学特性,采取针对性措施才能遏制新生儿感染的蔓延。Objective To analyze the causes and intervention measure efficacy of an outbreak of neonatal Pseudomonas aeruginosa(P.aeruginosa)infection in a medical institution.Methods The epidemiological investigation was conducted on 5 neonates who had P.aeruginosa infection in the neonatal intensive care unit(NICU)of this medical institution from May 26 to June 10,2024.Specimens were taken from potentially contaminated environments to infer the cause of P.aeruginosa transmission in the NICU,infection control measures were also taken,and the efficacy of the control measures was continuously monitored.Results Among the 5 infected neonates,3 had lower respiratory tract infection and 2 had lower respiratory tract combined with bloodstream infection.Seven strains of P.aeruginosa were detected with a consistent antimicrobial resistance spectrum.Infected neonates were in the same ward and had spatial and temporal clustering.Through environmental hygiene monitoring,P.aeruginosa with consistent antimicrobial resistance spectrum of neonatal infection was isolated from the NICU handwashing sink and water-related environment(suction connection pipe,bedside isolation gowns).Infection was controlled after improving sink disinfection methods and enhancing contact isolation measures,and no further P.aeruginosa was detected in the environment.Conclusion The outbreak of neonatal HAI in the NICU is inferred to be caused by contamination of ward handwashing sink by P.aeruginosa,then further contaminated the suction connection tube,thereby leading to the transmission of neonatal infection through suction procedures.Healthcare-associated infection surveillance and control professionals need to fully understand the characteristics of outbreak pathogens and take targeted measures to curb the transmission of neonatal infection.

关 键 词：铜绿假单胞菌 水槽 洗手池 医院感染暴发 新生儿重症监护病房 接触隔离 

分 类 号：R181.32[医药卫生—流行病学]