主动脉夹层手术患者疑似嗜水气单胞菌切口感染暴发的调查与控制

目的调查一起Standfond A型主动脉夹层术后嗜水气单胞菌深部手术切口疑似医院感染暴发的原因,为有效控制感染提供依据。方法 2018年9—10月某院心外重症监护病房(ICU)发生3例心脏术后手术部位嗜水气单胞菌感染,规范采集患者深部切口引流脓液和静脉全血,对菌株进行鉴定及药敏试验,并进行流行病学调查与分析。结果 3例主动脉夹层术后患者深部切口引流脓液及血液中检出嗜水气单胞菌,均对阿米卡星敏感,对其他抗菌药物耐药。2号患者的呼吸机外管道、3号患者床单元表面处均检出嗜水气单胞菌,且药敏试验结果与1号患者所在病区水池台面检出的嗜水气单胞菌一致。对患者进行隔离治疗,加强医务人员手卫生,严格执行接触隔离等措施后,未再出现新发嗜水气单胞菌医院感染病例。结论此次事件为疑似医院感染暴发,患者周围环境污染是可能的传播源。

A suspected outbreak of surgical incision infection caused by Aeromonas hydrophila in patients after aortic dissection operation

Objective To investigate the causes of a suspected outbreak of healthcare -associated infection(HAI) in deep surgical incision caused by Aeromonas hydrophila(A. hydrophila) after aortic dissection operation (Standfond A), and provide evidence for effective control of infection. Methods A. hydrophila infection occurred in 3 patients after cardiac surgery in an cardiothoracic surgery intensive care unit (ICU) from September to October 2018 were investigated, deep incision drainage pus and venous blood of patients was collected, identification and antimicrobial susceptibility testing of strains were performed, epidemiological investigation and analysis was carried out. Results A. hydrophila was isolated from deep incision drainage pus and blood of 3 patients after aortic dissection operation, all were sensitive to amikacin, but resistant to other antimicrobial agents. External duct of ventilator of patient No. 2 and surface of bed unit of patient No. 3 were also isolated A. hydrophila, antimicrobial susceptibility testing results were consistent with A. hydrophila isolated from countertop of sink in ward of patient No. 1. After taking measures, such as isolation treatment for patients, strengthening hand hygiene of health care workers(HCWs), and strict implementing contact isolation, no new case of HAI caused by A. hydrophila occurred. Conclusion This event is a suspected outbreak of HAI, environmental contamination in the vicinity of patients is a possible source of transmission.