神经重症监护室中肺炎克雷伯菌的流行病学特征研究

目的分析神经重症监护室(NICU)中肺炎克雷伯菌(KP)流行病学特征,为NICU的消毒管理和KP的感染控制提供科学合理的临床指导。方法选取2015—2018年在华北理工大学附属开滦总医院NICU住院的KP感染患者93例。采集KP感染患者KP及其床单位环境KP、NICU病房环境KP,采用脉冲场凝胶电泳(PFGE)技术分析KP间的同源性,进一步探讨KP感染患者与其床单位环境、NICU病房环境的关系。结果93例KP感染患者分离出KP 94株;患者所在床单位环境分离出KP 13株。聚类分析结果显示,KP感染患者与其床单位环境同源性100%的KP 15组,其中KP感染患者KP 24株,床单位环境KP 9株。同源性100%患者入住NICU时间间隔最长为117 d。结论KP是NICU常见致病菌,而空气传播是其主要传播途径,并可在NICU空气中定植4个月左右,且枕头、被子等也可传播KP。

Epidemiological Characteristics of Klebsiella Pneumoniae in the Neurological Intensive Care Unit

Objective To analyse the epidemiological characteristics of klebsiella pneumoniae(KP)in the neurological intensive care unit(NICU),in order to provide scientific and reasonable clinical guidance for the disinfection management of NICU and the control of KP infection.Methods A total of 93 patients with KP infection were hospitalized in the Department of NICU of Kailuan General Hospital Affiliated to North China University of Technology from 2015 to 2018.Patients with KP infection and their bed unit environment KP,NICU ward environment KP were collected,and homology of KP was analysed by pulse field gel electrophoresis(PFGE)technology,and further explored the relationship between KP infected patients and their bed unit environment,NICU ward environment.Results 94 KP strains were isolated from 93 patients with KP infection;13 KP strains were isolated from the patients'bed unit environment.The results of cluster analysis showed that,the KP infected patients had 100%homology with the bed unit environment of KP 15 group,among them,KP infected patients had KP 24 strains and bed unit environment KP 9 strains.The longest interval for patients with 100%homology to enter the NICU was 117 days.Conclusion KP is a common pathogen in NICU,and air transmission is its main transmission route.It can be colonized in the air of NICU for about 4 months,and pillows and quilts can also transmit KP.