新生儿科溶血性葡萄球菌导管相关血流感染的溯源调查与防控  

Traceability investigation and prevention of catheter-related bloodstream infections caused by Staphylococcus haemolyticus in the neonatal department

作　　者：刘丽君 牛俊 郑文萍 刘洋 林楚楚 LIU Li-jun;NIU Jun;ZHENG Wen-ping;LIU Yang;LIN Chu-chu(Department of Preventive Health Care and Nosocomial Infection Management,Shenzhen People's Hospital(the First Affiliated Hospital of Southern University of Science and Technology),Shenzhen 518020,Guangdong,CHINA)

机构地区：[1]深圳市人民医院(南方科技大学第一附属医院)预防保健与医院感染管理部,广东深圳518020

出　　处：《海南医学》2025年第8期1179-1182,共4页Hainan Medical Journal

摘　　要：目的调查新生儿科溶血性葡萄球菌导管相关血流感染情况,分析导致院内感染的原因,为感染防控提供参考依据。方法采集2024年6月13~16日某综合医院新生儿科连续发生的3例溶血性葡萄球菌导管相关血流感染患儿静脉血培养菌株、病区物表采样及医护手采样等标本进行培养及药敏试验,全基因组提取、测序及组装后进行多位点序列分型和基因组系统发育树构建,分析菌株同源性。结果新生儿科发生的溶血性葡萄球菌导管相关血流感染,经全基因组测序后多位点序列分型和基因组系统发育树构建后显示,4株(3株分别来自3例患儿静脉血,1株来自护士手)菌种均为ST3型,系统进化均与VB19458接近,结合暗访调查结果分析此次感染为医护手卫生不合格导致的交叉感染。结论新生儿科发生的溶血性葡萄球菌导管相关血流感染,经全基因测序及后续分析显示此次感染事件为医院感染暴发,该起暴发事件可能由于手卫生措施执行不到位,造成交叉感染,经积极采取一系列感染控制措施,患儿的感染得到良好的控制均痊愈出院。Objective To investigate cases of catheter-related bloodstream infections(CRBSIs)caused by Staphylococcus haemolyticus in the neonatology department,analyze the causes of nosocomial infections,and provide ref-erence for infection prevention and control.Methods Specimens including venous blood culture isolates from three consecutive cases of CRBSIs caused by Staphylococcus haemolyticus in the Neonatology Department of a comprehensive hospital(June 13 to 16,2024),environmental surface samples from the ward,and hand swabs from healthcare workers were collected for culture and antimicrobial susceptibility testing.Whole-genome extraction,sequencing,and assembly were performed,followed by multilocus sequence typing(MLST)and phylogenetic tree construction to analyze strain homology.Results Whole-genome sequencing and phylogenetic analysis revealed that all four isolates(three from the patients'blood and one from a nurse's hand)belonged to ST3,with evolutionary proximity to VB19458.Combined with covert investigation findings,the infections were attributed to cross-contamination due to inadequate hand hygiene among medical staff.Conclusion Genomic sequencing and subsequent analysis confirmed this event as a nosocomi-al outbreak of Staphylococcus haemolyticus CRBSIs,likely caused by poor hand hygiene compliance leading to cross-infection.Through prompt implementation of infection control measures,all affected neonates recovered and were discharged.

关 键 词：溶血性葡萄球菌 导管相关血流感染 全基因组测序 多位点序列分型 

分 类 号：R722.1[医药卫生—儿科]