本文選題：泛耐藥鮑氏不動(dòng)桿菌 + 醫(yī)院感染暴發(fā)　； 參考：《中華醫(yī)院感染學(xué)雜志》2016年20期

【摘要】：目的調(diào)查神經(jīng)外科重癥監(jiān)護(hù)病房(NSICU)泛耐藥鮑氏不動(dòng)桿菌醫(yī)院感染,查找感染源和傳播途徑,為預(yù)防和控制醫(yī)院感染提供參考依據(jù)。方法采集2015年1月初NSICU 4例感染患者標(biāo)本(氣道深部痰)及醫(yī)務(wù)人員手和NSICU物體表面等環(huán)境標(biāo)本,進(jìn)行培養(yǎng)鑒定和藥敏試驗(yàn),采用16S-23SrRNA基因測(cè)序分析技術(shù)對(duì)分離出的泛耐藥鮑氏不動(dòng)桿菌進(jìn)行同源性分析。結(jié)果 NSICU泛耐藥鮑氏不動(dòng)桿菌感染罹患率達(dá)36.36%(4/11),4株菌經(jīng)16S-23SrRNA基因測(cè)序分析,同源性大于98%;NSICU環(huán)境監(jiān)測(cè)在呼吸機(jī)面屏檢出1株泛耐藥鮑氏不動(dòng)桿菌,其耐藥譜與4位患者感染的病原菌相似,經(jīng)16S-23SrRNA基因測(cè)序分析,同源性大于98%。結(jié)論該院NSICU發(fā)生的泛耐藥鮑氏不動(dòng)桿菌醫(yī)院感染,經(jīng)同源性分析確認(rèn)為醫(yī)院感染暴發(fā),調(diào)查顯示,患者A為感染源,病原菌可能通過(guò)污染的呼吸機(jī)面屏間接接觸傳播,導(dǎo)致本次感染暴發(fā),經(jīng)積極采取有效控制措施疫情得到及時(shí)控制。
[Abstract]:Objective to investigate the nosocomial infection of Acinetobacter baumannii pan-resistant in neurosurgical intensive care unit (ICU), to find out the source of infection and to provide reference for the prevention and control of nosocomial infection. Methods four specimens of NSICU infected patients (deep phlegm in airway), hand and surface of NSICU objects were collected in early January, 2015, and the culture and drug sensitivity tests were carried out. The homology of pan-resistant Acinetobacter baumannii was analyzed by 16S-23SrRNA gene sequencing. Results the infection rate of Acinetobacter baumannii Pan-resistant NSICU was 36.36% and 4 / 11 strains were analyzed by 16S-23SrRNA gene sequencing. A pan-resistant Acinetobacter baumannii was detected on ventilator screen by environmental monitoring of NSICU with more homology than 98%. The drug resistance spectrum was similar to that of the pathogens infected in 4 patients, and the homology was greater than 98 by 16S-23SrRNA gene sequencing. Conclusion the nosocomial infection of Acinetobacter baumannii occurred in NSICU of our hospital was confirmed as nosocomial infection by homology analysis. The investigation showed that patient A was the source of infection and the pathogen might be transmitted indirectly by contaminated ventilator screen. As a result of this infection outbreak, effective control measures were taken to control the epidemic in time.
【作者單位】： 南方醫(yī)科大學(xué)珠江醫(yī)院感染科;
【基金】：廣東省省級(jí)科技計(jì)劃項(xiàng)目(2013B021800155)
【分類號(hào)】：R446.5;R197.323

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