一起肺炎克雷伯菌聚集性定植的调查与控制
Investigation and control of Klebsiella pneumoniae clustering colonization
李克彬 1余蔚仙 1李芝应 1田兴武 1张永红 1周仕军 1简旭龙 1陶小波 1邓崇第2
作者信息
- 1. 思南县人民医院(贵州铜仁 565100)
- 2. 遵义医科大学第二附属医院(贵州遵义 563000)
- 折叠
摘要
目的 通过调查重症监护病房(intensive care unit,ICU)一起肺炎克雷伯菌(Klebsiella pneumoniae,KP)聚集性定植原因,评价防控措施的有效性.方法 对2020年4月8日至6月28日入住ICU检出KP的患者进行流行病学调查及其病房周围环境监测,并进行药敏试验.结果 2020年第二季度KP检出例次阳性率为10.58％(20/189),高于去年同期水平(x2=6.68,P=0.01),调查期内入住ICU患者119人次,其中10名患者痰培养KP阳性,1例为呼吸机相关性肺炎(ventilator associated pneumonia,VAP),9例为院内定植,其主要发现于4、8、9、11、13、16床,其中8、9两床共计检出5例;对ICU病房环境采样45份,石蜡油瓶表面及导丝盒中检出KP;石蜡油瓶表的KP菌株和10位患者检出的KP抗菌谱完全一致或高度相似.结论 本次KP聚集事件传播途径主要考虑为床间.交叉使用表面被KP污染的石蜡油瓶,采取相应的防控措施后得到有效控制.
Abstract
Objective To evaluate the effectiveness of prevention and control measures by investigating the causes of Klebsiella pneumoniae(KP)aggregation colonization in an intensive care unit(ICU).Methods Epidemiological investiga-tion of patients admitted to ICU with detectable KP from April 8 to June 28,2020 and environmental monitoring of their ward surroundings with drug sensitivity testing.Results The positive rate of KP detection cases in the second quarter of 2020 was 10.58％(20/189),which was higher than the level in the same period last year(x2=6.68,P=0.01).119 patients were admitted to ICU during the survey period,of which 10 patients had positive sputum culture for KP,1 case was ventilator associated pneumonia(VAP),and 9 cases of in-hospital colonization,which were mainly found in beds 4,8,9,11,13,and 16,of which a total of 5 cases were detected in beds 8 and 9.Forty-five samples were taken from the ICU ward environment,and KP was detected on the surface of the paraffin oil bottle and in the guide wire box;the KP strains on the surface of the paraffin oil bottle and the antimicrobial spectrum of KP detected in 10 patients were identical or highly similar.Conclusion The transmission route of this KP gathering event was mainly considered to be the cross-use of paraffin oil bottles contam-inated with KP on the surface between beds,which was effectively controlled after taking corresponding prevention and con-trol measures.
关键词
ICU/KP/聚集性定植/医院感染/环境监测Key words
ICU/KP/clustering colonization/healthcare associated infection/environmental monitoring引用本文复制引用
基金项目
贵州省卫生健康委科学技术基金项目(gzwkj2021-079)
出版年
2024
NETL
NSTL
万方数据