三种肺外菌菌感染的集群与维护良好的水基加热-冷却器件相关
Jessica L Seidelman1,2, Arthur W Baker1,2, Sarah S Lewis1,2
1Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina.
Infection control and hospital epidemiology
|December 21, 2023
概括
热冷器设备 (HCDs) 传染了Mycobacterium给三名患者,尽管清洁协议. 需要进行设计更改,以防止非结核性真菌菌从HCD传播.
科学领域:
- 与医疗保健相关的感染
- 传染病流行病学 传染病流行病学
- 医疗器械安全 医疗器械安全
背景情况:
- 基于水的加热器-冷却器设备 (HCD) 与非结核性真菌菌 (NTM) 爆发有关.
- 严格的监测发现了心胸外科手术患者的三个肺外菌 (M. abscessus) 感染的集群.
- 这一集群促使人们对与医疗保健相关的M. (HA-Mab) 的潜在来源进行调查.
研究的目的:
- 在一组手术患者中调查M.的来源和传播途径.
- 评估HCD在HA-Mab传播中的作用.
- 确定必要的干预措施,以防止未来的NTM爆发.
主要方法:
- 一个多学科团队审查了HCD清洁和维护协议.
- 环境和患者样本被收集用于M.的分析.
- 多位元序列类型和脉冲场凝电泳用于分子比较.
- 烟雾测试评估了来自HCD的气溶产生.
主要成果:
- 在患者护理中使用的HCD中分离了M. abscessus.
- 分子分析证实了患者和环境隔离物之间的克隆性.
- 烟雾测试显示,在HCD操作过程中,M. abscessus的气溶化.
- 取代HCD舰队阻止了这种特定的M.的进一步传播.
结论:
- 即使使用增强的清洁方案,HCD也可以将M.传染给患者.
- 当前的HCD设计可能会促进NTM的殖民化和空气化.
- 对HCD的修改,例如改善气溶封闭或废气过,对于防止NTM传播至关重要.
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