多剤耐性Acinetobacter baumanniiの発生は,脈動性洗浄による傷口治療に関連しています

Lisa L Maragakis¹, Sara E Cosgrove, Xiaoyan Song

¹Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md, USA. lmaraga1@jhmi.edu

JAMA

|December 23, 2004

まとめ

脈動性洗い流し,傷の治療法,流行の間に多剤耐性Acinetobacter baumanniiが伝播する. この処置では,環境汚染と患者の感染拡大を防ぐために,強化された感染対策が不可欠です.

科学分野:

感染症疫学感染症疫学
ヘルスケア関連感染症
創傷ケア管理創傷ケア管理

背景:

脈動性洗浄は,一般的な高圧傷口脱血技術です.
脈動性洗浄の間,通常の感染対策は標準的なものではありません.
確立されたプロトコルの欠如は,病原体の伝播を容易にする可能性があります.

研究の目的:

多剤耐性バクテリアバウマンニ (MDRAB) の発生を調査する.
脈動性洗浄がMDRABの伝播経路であったかどうかを判断する.
脈動性洗浄とMDRAB取得との関連性を評価する.

主な方法:

MDRABの発生時にケース・コントロール調査を行った.
症例識別,医療記録のレビュー,環境文化などが含まれています.
ストレントイピングのためにパルスフィールドゲル電泳法 (PFGE) を利用しました.

主要な成果:

医療関連のMDRAB症例10例のうち8例はパルス式洗浄を受けた.
脈動性洗浄は重大なリスク因子であった (OR,36;P<.001).
同様のMDRAB菌株が,患者および機器の表面で発見されました.

結論:

脈動性洗浄はMDRABを伝達し,環境汚染を引き起こした可能性がある.
脈動性洗浄の際には,感染症対策が不可欠です.
機器のラベルには,感染制御のガイドラインが含まれている必要があります.

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