一起NICU导管相关血流感染的流行病学调查及处置
Epidemiologic investigation of catheter-associated bloodstream infections in NICU
孙吉花 1李戈 2宋洪芳 1刘芳 1刘欣 1姜雪锦 1李华 1魏佳 1纪冰 3樊国爱1
作者信息
- 1. 滨州医学院附属医院感染管理办公室,山东滨州 256603
- 2. 滨州市疾病控制中心,山东滨州 256600
- 3. 滨州医学院附属医院检验科,山东滨州 256603
- 折叠
摘要
目的 对新生儿重症监护病房(NICU)导管相关血流感染(CRBSI)疑似医院感染暴发进行流行病学调查,为感染防控提供科学依据.方法 对2023年5月28日-6月24日感染患儿三间分布进行调查,采集NICU环境卫生学标本、主动筛查医务人员鼻腔及手,查找金黄色葡萄球菌(SA),与患儿血培养检测出的菌株进行脉冲场凝胶电泳(PFGE)检测,分析同源性.结果 NICU患儿CRBSI感染率为2.29‰,医务人员鼻腔SA阳性率为32.35％,手阳性率为1.47％;PFGE检测分析,2例患儿血培养菌株与一护士鼻腔菌株有91.30％的相似度,1例患儿血培养菌株与另一护士手菌株有91.30％的相似度.结论 3例CRBSI患儿与医务人员鼻腔定植SA、手卫生有关,为2个感染路径,排除医院感染暴发.应高度重视NICU医务人员鼻腔SA定植,及时去定植管理,严格落实手卫生,积极降低医院感染发生率.
Abstract
OBJECTIVE To investigate the epidemiology of catheter-related bloodstream infections(CRBSI)in a neonatal intensive care unit(NICU),and in order to provide a scientific basis for infection prevention and control.METHODS The three-room distribution of infected children from May 28 to Jun 24,2023 was investigated.Envi-ronmental hygiene samples were collected from the NICU.The nasal passages and hands samples of medical staff were actively screened to find Staphylococcus aureus(SA).And pulsed-field gel electrophoresis(PFGE)was per-formed to analyze the homology with the strains detected by blood culture of the children.RESULTS The rate of CRBSI infection in children in NICU was 2.29‰,nasal SA-positive rate among medical staff was 32.35％,and hand SA-positive rate was 1.47％.PFGE test analysis showed that strains isolated from blood culture of two chil-dren's specimens had 91.30％similarity to one strain from a nurse's nasal specimen,and one strain from child's blood culture was 91.30％similar to a strain from another nurse's hand.CONCLUSION Three children with CRBSI were related to nasal colonization of SA and hand hygiene of medical staff,which are the two pathways of infec-tion,excluding outbreak of nosocomial infection.Great attention should be paid to the nasal SA colonization of NICU medical staff,and timely de-colonization management,strict implementation of hand hygiene should be car-ried out,in order to actively reduce the incidence of hospital infections.
关键词
新生儿/导管相关血流感染/疑似医院感染暴发/流行病学调查/金黄色葡萄球菌Key words
Neonate/Catheter-related bloodstream infection/Suspected hospital-acquired infection outbreak/Epi-demiologic investigation/Staphylococcus aureus引用本文复制引用
基金项目
山东省自然科学基金面上项目(ZR2020MH309)
出版年
2024
NETL
NSTL
万方数据