重症监护室鲍曼不动杆菌肺部感染暴发调查与控制

Outbreak and control of Acinetobacter baumannii pulmonary infection in an intensive care unit

摘要:

目的探讨重症监护室(ICU)鲍曼不动杆菌肺部感染暴发流行的原因、控制感染的有效措施，以减少类似医院感染事件的发生。方法采取前瞻性和回顾性相结合的调查方法对在ICU目标性监测中2周内出现的7例聚集性鲍曼不动杆菌肺部感染病例进行流行病学调查和环境卫生学监测，分析各种危险因素并采取相应的防控措施控制感染。结果ICU 泛耐药鲍曼不动杆菌感染罹患率达28.00%(7/25)； ICU环境存在污染，痰培养鲍曼不动杆菌与环境中分离的鲍曼不动杆菌药敏试验结果耐药谱相似。经采取相关措施后，ICU鲍曼不动杆菌感染得到有效控制。结论ICU环境污染导致此次鲍曼不动杆菌肺部感染流行。环境清洁能够预防控制鲍曼不动杆菌感染的暴发流行。

关键词:

鲍曼不动杆菌;肺部感染;医院感染;暴发;流行病学;泛耐药;多重耐药;抗药性，微生物

Abstract:

ObjectiveTo evaluate the causes and control measures of outbreak of Acinetobacter baumannii (A. baumannii) pulmonary infection in an intensive care unit (ICU), so as to reduce the incidence of such infection.MethodsEpidemiological investigation and environmental hygiene monitor were performed on 7 cases of clustering A.baumannii pulmonary infections in ICU within 2 weeks by prospective and retrospective investigation, various risk factors were analyzed and appropriate measures were taken to control the infection.ResultsPrevalence of pandrugresistant A. baumannii infection in ICU was 28.00%(7/25); ICU environment was contaminated, drugresistant pattern of A. baumannii from sputum culture and environment was similar, A. baumannii infection was controlled after appropriate measures were taken.ConclusionEnvironmental contamination in ICU was the cause of the outbreak of A. baumannii pulmonary infection. Environmental cleaning can prevent and control outbreak of A. baumannii infection.

Key words:

Acinetobacter baumannii; pulmonary infection; healthcareassociated infection; outbreak; epidemiology; pandrug resistance; multidrug resistance; drug resistance, microbial