ICU多重耐药鲍曼不动杆菌暴发调查与分析(1)
[摘要] 目的 研究在重症监护室(ICU)治疗中暴发多重耐药鲍曼不动杆菌医院感染的基本情况，且给出有效处理方式。方法 该次回顾性分析样本来源于阜宁县人民医院自2016年6—7月期间收治的6例重症监护室(ICU)暴发多重耐药鲍曼不动杆菌疑似医院感染患者所有数据资料，观察ICU分离的多重耐药鲍曼不动杆菌不同药物的药敏试验情况以及环境卫生学监测结果。结果 此次数据统计研究中共采集标本132份，重症监护室(ICU)暴发多重耐药鲍曼不动杆菌疑似医院感染样本，来自呼吸机按钮、袖带、门把手、工作台面、键盘、拖把、输液泵13份标本中进行多重耐药鲍曼不动杆菌的分离；经培养分离之后鲍曼不动杆处理中度敏感左氧氟沙星，高度敏感舒巴坦/头孢哌酮，其余抗菌药物分离之后显示基本耐药。结论 重症监护室暴发多重耐药鲍曼不动杆菌医院感染极有可能与医疗环境污染、医护人员手感染存在一定关系，因此有效消毒设备与环境，做好手卫生工作可预防多重耐药鲍曼不动杆菌医院感染。
[关键词] ICU；多重耐药；鲍曼不动杆菌；暴发；医院感染
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)03(c)-0177-03
Investigation on Outbreak of ICU Multiple Resistance Acinetobacter Baumannii
ZHU Zheng-juan
Department of Clinical Laboratory， Funing People’s Hospital， Yancheng， Jiangsu Province， 224400 China
[Abstract] Objective To research the basic condition of outbreak of ICU multiple resistance acinetobacter baumannii and put forwards the effective treatment method. Methods 6 cases of patients suspected with ICU multiple resistance acinetobacter baumannii admitted and treated in June to July 2016 were selected and the drug sensitivity test and environmental hygiene monitoring results isolated from multiple resistance acinetobacter baumannii were observed. Results Of 132 pieces of collected specimens， the multiple resistance acinetobacter baumannii was isolated from the button ofrespirator， cuff， doorknob， work surface， keyboard， mop and infusion pump (13 specimens)， after the culture and isolation， the sensitivity of acinetobacter baumannii to levofloxacin was moderate， and the sensitivity to the sulbactam/cefoperazone was high， and the other antibacterial drugs after isolation was basically drug-resistant. Conclusion The outbreak of ICU multiple resistance acinetobacter baumannii is probably related to the contamination of medical environment and hand infection of medical staff， therefore， the effective disinfection facilities and environment and doing well in the hand hygiene work can prevent the hospital infection of multiple resistance acinetobacter baumannii.
[Key words] ICU； Multiple resistance； Acinetobacter baumannii； Outbreak； Hospital infection
鮑曼不动杆菌是于自然界、人体皮肤、医院环境中广泛分布的病菌，是诱发医院感染的革兰阴性非发酵病原菌，具有较强生存能力以及抵抗力强、耐药性高等特点，可存活于干燥表面，表现为泛耐药性以及耐药性[1]。现分析2016年6—7月期间收治的6例重症监护室(ICU)暴发多重耐药鲍曼不动杆菌疑似医院感染患者调查研究结果，报道如下。
1 资料与方法
1.1 一般资料
该次研究的样本选自重症监护室(ICU)暴发多重耐药鲍曼不动杆菌疑似医院感染患者，其中多重耐药鲍曼不动杆菌下呼吸道感染发生例数为6例，见表1。所有患者均自愿签署获取该院伦理委员会认可的同意书。
1.2 方法
对所有患者均进行无菌取血，制作合理的痰液标本，将样本放置于无菌瓶内进行送检，常规取样处理呼吸机按钮、袖带、门把手、工作台面、键盘、拖把、输液泵等样本，选择梅里埃生物公司研发的全自动微生物分析系统进行环境监测标本，大肠埃希菌ATCC5922显示为质控菌，选择美国临床实验室标准化委员会的相关标准来进行药敏试验，将其送入该市医院感染控制中心对临床分离菌株同源性渐进性脉冲场凝胶电泳检验。, 百拇医药(朱正娟)
[关键词] ICU；多重耐药；鲍曼不动杆菌；暴发；医院感染
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)03(c)-0177-03
Investigation on Outbreak of ICU Multiple Resistance Acinetobacter Baumannii
ZHU Zheng-juan
Department of Clinical Laboratory， Funing People’s Hospital， Yancheng， Jiangsu Province， 224400 China
[Abstract] Objective To research the basic condition of outbreak of ICU multiple resistance acinetobacter baumannii and put forwards the effective treatment method. Methods 6 cases of patients suspected with ICU multiple resistance acinetobacter baumannii admitted and treated in June to July 2016 were selected and the drug sensitivity test and environmental hygiene monitoring results isolated from multiple resistance acinetobacter baumannii were observed. Results Of 132 pieces of collected specimens， the multiple resistance acinetobacter baumannii was isolated from the button ofrespirator， cuff， doorknob， work surface， keyboard， mop and infusion pump (13 specimens)， after the culture and isolation， the sensitivity of acinetobacter baumannii to levofloxacin was moderate， and the sensitivity to the sulbactam/cefoperazone was high， and the other antibacterial drugs after isolation was basically drug-resistant. Conclusion The outbreak of ICU multiple resistance acinetobacter baumannii is probably related to the contamination of medical environment and hand infection of medical staff， therefore， the effective disinfection facilities and environment and doing well in the hand hygiene work can prevent the hospital infection of multiple resistance acinetobacter baumannii.
[Key words] ICU； Multiple resistance； Acinetobacter baumannii； Outbreak； Hospital infection
鮑曼不动杆菌是于自然界、人体皮肤、医院环境中广泛分布的病菌，是诱发医院感染的革兰阴性非发酵病原菌，具有较强生存能力以及抵抗力强、耐药性高等特点，可存活于干燥表面，表现为泛耐药性以及耐药性[1]。现分析2016年6—7月期间收治的6例重症监护室(ICU)暴发多重耐药鲍曼不动杆菌疑似医院感染患者调查研究结果，报道如下。
1 资料与方法
1.1 一般资料
该次研究的样本选自重症监护室(ICU)暴发多重耐药鲍曼不动杆菌疑似医院感染患者，其中多重耐药鲍曼不动杆菌下呼吸道感染发生例数为6例，见表1。所有患者均自愿签署获取该院伦理委员会认可的同意书。
1.2 方法
对所有患者均进行无菌取血，制作合理的痰液标本，将样本放置于无菌瓶内进行送检，常规取样处理呼吸机按钮、袖带、门把手、工作台面、键盘、拖把、输液泵等样本，选择梅里埃生物公司研发的全自动微生物分析系统进行环境监测标本，大肠埃希菌ATCC5922显示为质控菌，选择美国临床实验室标准化委员会的相关标准来进行药敏试验，将其送入该市医院感染控制中心对临床分离菌株同源性渐进性脉冲场凝胶电泳检验。, 百拇医药(朱正娟)