光ファイバーブロンコスコープによるMycobacterium tuberculosisの感染. DNA指紋による識別
T M Michele1, W A Cronin, N M Graham
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2179, USA.
JAMA
|October 7, 1997
まとめ
汚染されたブロンコスコープは,おそらく2人の患者の間で結核 (TB) を伝達した. 分子型化により,病院内での感染が確認され,さらなる感染を防ぐために厳格な内視鏡浄化プロトコルの必要性を強調した.
科学分野:
- 感染症疫学 感染症疫学
- 分子微生物学 分子微生物学
- 病院感染症対策は,病院感染対策です.
背景:
- Mycobacterium tuberculosisの単離体に関する進行中の制限断片長ポリモルフィズム (RFLP) 研究.
- 同様のIS6110 RFLPパターンが6ヶ月間隔で診断された2人の結核患者で発見されました.
- 2人の患者の間の唯一のリンクとして特定された病院での共同ケア.
研究 の 目的:
- 2人の患者の間で,Mycobacterium tuberculosisのノソコミアル感染の可能性を調査する.
- 送信源を特定し,制御措置を実施する.
主な方法:
- 伝統的および分子的疫学調査を実施しました.
- メディカルチャート,支氣管顕微鏡記録,両患者が頻繁に通った病院の場所を調べました.
- 病院の換気システムを評価し,支氣管顕微鏡による浄化と消毒手順を観察した.
主要な成果:
- 2人の患者は同じ手術室で同じ器具でブロンコスコピーを施し,介入の手続きはありませんでした.
- ブロンコスコープの洗浄と消毒の手順が一貫せず,国家ガイドラインから逸脱していることが確認されました.
- ミコバクテリウム結核は,ブロンコスコーピーの後の2番目の患者で,最初の患者と同一のRFLPパターンで特定されました.
結論:
- 感染したブロンコスコープが,この2人の患者の間でのMycobacterium tuberculosisの感染源として最も可能性が高いと判明した.
- 制限断片長ポリモルフィズム (RFLP) 分析は,この病院内伝播を検出する上で極めて重要でした.
- この調査結果は,医療関連感染症を予防するために,厳格な内視鏡の浄化と消毒プロトコルに従うことが極めて重要であることを強調しています.
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