呼吸重症监护病房多药耐药鲍氏不动杆菌医院感染暴发流行调查及控制对策

目的 总结呼吸重症监护病房(RICU)多药耐药鲍氏不动杆菌(MDRABA)医院感染暴发流行的原因,探讨防控的有效对策.方法 对RICU 2009年4月3-30日机械通气患者发生下呼吸道MDRABA感染进行流行病学调查.结果 27 d连续发生6例机械通气患者下呼吸道MDRABA感染,其中5例治愈,1例原发病重自动出院;6例患者下呼吸道痰标本中均分离出相同耐药谱的MDRABA.结论 医务人员诊疗操作中洗手缺乏依从性和规范性;室内环境、空气消毒机监管不力是引起此次机械通气患者下呼吸道MDRABA感染暴发流行的主要原因;应严格隔离患者,加强全员执行洗手的依从性和规范性教育,对住院患者进行常规多药耐药菌筛选,采取早期干预措施,预防医院感染暴发流行.

Multi-drug Resistant Acinetobacter baumannii Nosocomial Infection Outbreak in RICU:Investigation and Control Measures

OBJECTIVE To analyze multi-drug resistant Acinetobacter baumannii (ABA) outbreak of nosocomial infection in the respiratory intensive care unit (RICU), to explore effective measures for prevention and control.METHODS In RICU on April 3 to 30 2009, patients under mechanical ventilation in the respiratory tract with MDRABA were conductd epidemiological surveys. RESULTS On 27 consecutive days, six cases occurred in mechanical ventilation in patients with lower respiratory tract MDRABA infection, of which 5 patients were cured;6 cases of lower respiratory tract of patients in sputum specimens isolated the same resistance spectrum MDRABA. CONCLUSIONS Medical personnel lack the consciousness of washing their hands. Indoor environment, air disinfection machine lack of supervision in mechanical ventilation patients with lower respiratory tract MDRABA, were the main reasons of infection outbreak. Strict isolation of patients should be strengthened,full implementation of hand-washing compliance, education, conventional screening, early intervention to prevent outbreak of hospital infection.