某儿童医院PICU一起疑似CRKP医院感染暴发的流行病学调查

目的 分析一起疑似耐碳青霉烯类肺炎克雷伯菌（CRKP）医院感染暴发的流行病学特征，为医院感染预防与控制提供依据。方法 采用现场流行病学与环境卫生学检测相结合的方法调查2019年6月19日-7月10日某儿童医院儿科重症监护病房（PICU）住院后检出CRKP的患者，分析原因并采取相应的预防控制措施。结果 流行病学调查结果显示，6例检出CRKP病例中，5例为医院感染（3例下呼吸道感染，1例菌血症，1例导管相关血流感染），1例为定植。共采集177份环境卫生学标本，2份标本（吊塔和洁地巾）检出CRKP，其余标本均未检出。采取控制措施后，至2019年7月底PICU未再出现类似新发病例。结论 此次疑似CRKP医院感染暴发可能通过PICU环境表面和医务人员手传播，加强医务人员手卫生和采取严格的消毒措施，可有效控制CRKP的进一步流行。

Epidemiological investigation of a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae healthcare-associated infection in pedia-tric intensive care unit of a children's hospital

Objective To analyze the epidemiological characteristics of a suspected outbreak of carbapenem-resis-tant Klebsiella pneumoniae (CRKP) healthcare-associated infection(HAI), provide evidence for prevention and control of HAI. Methods Field epidemiological and environmental hygiene detection methods were adopted to investigate patients with CRKP during hospitalization in pediatric intensive care unit(PICU) of a children''s hospital from June 19 to July 10, 2019, the causes were analyzed and appropriate prevention and control measures were taken. Results Epidemiological investigation showed that 6 patients were isolated CRKP, and 5 of whom had HAI (3 cases of lower respiratory tract infection, 1 case of bacteremia, 1 case of catheter-related bloodstream infection), 1 case was colonization. A total of 177 environmental hygiene specimens were collected, 2 specimens (hanging tower and floor towel) were isolated CRKP, the remaining specimens were not found CRKP. After taking control mea-sures, no similar new cases occurred in the PICU until the end of July 2019. Conclusion The suspected outbreak of CRKP HAI may be transmitted through the surface of PICU environment and hands of health care workers, strengthening hand hygiene of HCWs and taking strict disinfection measures can effectively control the further pre-valence of CRKP.