一个重症监护病房爆发了多种药物耐药的Pseudomonas aeruginosa - - 聚焦在水槽上
V Schärer1, M-T Meier1, R A Schuepbach2
1Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
The Journal of hospital infection
|June 21, 2023
概括
洗手盆的移除和无水的护理阻止了重症监护室的多药耐药性Pseudomonas aeruginosa疫情. 这突出了水槽作为医院获得感染的潜在来源.
科学领域:
- 传染性疾病 传染性疾病
- 医院流行病学 医院流行病学
- 微生物学 微生物学
背景情况:
- 医疗相关感染 (HAI) 带来了重大风险,通常与病原体的环境持久性有关.
- 格拉姆阴性细菌,如Pseudomonas aeruginosa,在潮湿的医疗环境中壮成长,促进传播.
- 控制疫情需要了解环境水库和有效的干预策略.
研究的目的:
- 在重症监护室 (ICU) 调查和制一种多药耐药的Pseudomonas aeruginosa疫情.
- 确定疫情菌株的环境来源,并评估控制措施.
- 评估水槽作为细菌持久性和传播的潜在点源的作用.
主要方法:
- 从患者和环境中进行了广泛的环境采样和Pseudomonas aeruginosa分离物的分子表征.
- 实施干预措施,包括更换水槽吸管,清除水槽,以及无水患者护理协议.
- 使用多位置序列类型 (MLST) 来确认菌株的克隆性.
主要成果:
- 该疫情涉及2019年3月至11月期间的29名患者.
- 疫情菌株在三个重症监护室的水槽吸管和胃镜上被确定.
- 清除水槽和无水处理成功终止了疫情爆发,在最初的吸管更换后观察到重新生长.
结论:
- 除掉水槽,加上无水的病人护理,有效地结束了多药耐药性Pseudomonas aeruginosa疫情.
- 重症监护室的水槽可以作为Pseudomonas aeruginosa疫情的关键点来源.
- 尽量减少自来水的使用和去除潜在的水库是防止格拉姆阴性细菌持久性和HAI的关键.
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