多耐药洋葱伯克霍尔德菌医院感染暴发调查

An outbreak of healthcareassociated infection caused by multidrugresistant Burkholderia cepacia

摘要:

目的对某院多耐药洋葱伯克霍尔德菌医院感染暴发流行进行调查，查找传染源和传播途径，为预防和控制医院感染提供参考。方法采集患者标本和环境标本进行培养，根据医院感染诊断标准、区域分布、暴露时间判断是否为暴发。结果从感染患者痰标本分离出病原菌4株，均为多耐药洋葱伯克霍尔德菌。4例感染者均来自重症监护室同一病区，床位相邻；发病时间集中，为2011年1月16—22日。环境标本分离病原菌5株，分别分离自上述患者所在病区的床头柜、呼吸机管道、治疗车、被子、医务人员手，其他病房环境中未检出该菌。患者来源和环境来源的病原菌耐药谱基本一致。结论此次多耐药洋葱伯克霍尔德菌医院感染的暴发流行主要是重症监护室医疗用品被该菌污染所致。

Abstract:

ObjectiveTo investigate an outbreak of healthcareassociated infection(HAI) caused by multidrugresistant Burkholderia cepacia (B.cepacia)， trace the sources and transmission routes of infection, and provide reference for the prevention and control of HAI.MethodsSpecimens from patients and environment were taken and cultured, outbreak was determined based on HAI diagnostic criteria, regional distribution, and exposure time.ResultsFour B.cepacia isolates were isolated from sputum specimens of infected patients, all were multidrugresistant strains. Four infected patients were all from the same ward of the intensive care unit(ICU), their beds were adjacent, onset time was from 16 January to 22 January,2011. Five B.cepacia isolates were isolated from environment specimens, including patients’ward bedside cabinets, ventilator tubes, dressing trolleys, quilts, hands of health care workers, but B.cepacia was not detected from environment in the other wards. Drugresistant spectrum of B.cepacia  from both patients and environment was basically identical.ConclusionThe outbreak of multidrugresistant B.cepacia HAI is due to the contamination of B.cepacia on ICU medical supplies.