ICU耐甲氧西林金黄色葡萄球菌感染暴发原因分析及对策

目的 分析ICU耐甲氧西林金黄色葡萄球菌(MRSA)感染暴发的原因,探讨预防控制的有效措施.方法 对ICU 2011年1月29日-2月10 日相继发生的4例MRSA肺部感染患者开展流行病学调查,并采取干顶措施控制感染流行.结果 入住ICU＜14 d相继有4例患者发生MRSA肺部感染,痰标本中分离到相同药敏谱的MRSA,是一起医院感染暴发；ICU环境取样检测,采集标本116份,其中阳性标本26份,阳性率22.4％；医务人员手、写字台、床间隔离布帘、床栏、床垫等标本分离到相同约敏谱MRSA；采取干预措施,将MRSA感染患者集中隔离,加强工作人员手卫生及医疗环境的清洁、消毒,有效地控制了感染流行.结论 在节假日期间 ICU管理存在疏漏,医疗环境污染严重及医护人员手卫生依从性较差,是造成感染暴发的主要原因.

Causes for methicillin-resistant Staphylococcus aureusinfection in ICU and its countermeasures

OBJECTIVE To analyze the causes for outbreak of methicillin-resistant Staphylococcus aureus infection in ICU,and discuss the effective measures for prevention an control.METHODS Totally 4 cases of pulmonary infections caused by methicillin-resistant Staphylococcus aureus from Jan 29 to Feb 10 2011 were developed for epidemiological study,and intervention countermeasures were taken for the control of the prevalence of infection.RESULTS Totally 4 cases with less than 14 days were occurred with methicillin-resistant S.aureus pulmonary infections,MRSA isolated from the sputum samples had the same susceptibility spectrum,and it was an outbreak of nosocomial infection;116 samples were collected from the environment in ICU,among which 26 were positive samples with the positive rate of 22.4%;the susceptibility spectrum of MRSA isolated from the hands of medical personnel,the desk,isolation bed curtains,bed rails and mattress was same;to take the intervention measures,separate the patients with MRSA infections,and strengthen hand hygiene compliance,cleaning and disinfection of medical environment has controlled the infection effectively.CONCLUSION The neglect of the management in ICU during the holidays,serious environmental pollution and the poor hand hygiene compliance are the main causes for the infections.