血液科铜绿假单胞菌血流感染流行病学调查报道

Investigation Report of Epidemiology of Pseudomonas aeruginosa Bloodstream Infection in Department of Hematology

目的调查血液科铜绿假单胞菌血流感染流行病学的情况。方法对血液内科病房3例白血病患者发生铜绿假单胞菌血流感染进行临床资料及危险因素调查,并行环境微生物监测、分子流行学调查。结果环境微生物采样中48份标本共检出3株铜绿假单胞菌,其中患者口腔溃疡面1株,治疗室水龙头1株,拖把池排水口1株;对分离出的3株铜绿假单胞菌和1例患者的血培养铜绿假单胞菌(另两例患者的血培养标本未保留)进行随机扩增多态性DNA(RAPD)基因分型显示2株为Ⅰ型,Ⅱ、Ⅲ型各1株,1例患者口腔溃疡面和血培养标本铜绿假单胞菌基因型相同,而与拖把池排水口和治疗室水龙头的标本铜绿假单胞菌基因型都不相同。结论该次血液科病房3例白血病患者发生铜绿假单胞菌血流感染,不能断定为医院感染暴发。

OBJECTIVE To explore the condition of Pseudomonas aeruginosa bloodstream infections in the department of hematology. METHODS The clinical data and risk factors were analyzed, to monitor the environmental microbes, and to survey the molecular epidemiology for three leukemia patients in the hematology ward who were found with P. aeruginosa bloodstream infections. RESULTS The strains of P. aeruginosa were isolated in the 48 specimens of environmental microbqs and the 3 strains were isolated from one oral ulcer on Patient Ni, one faucet in the treatment room, and the drain of a mop sink. The three isolated strains of P. aerug- inosa and the single blood culture grown from the P. aeruginosa from Patient Ni（the other two patientst blood culture samples were not retained）underwent random amplified polymorphic （RAPD） DNA genotyping. The results showed that two strains were type I ; one was, type Ⅱ and one was type Ⅲ. The genotype of the P. aeruginosa sample from Patient Ni＇s oral ulcer was the same as the genotype of the blood culture, but was different from the genotypes of the exam room faucet sample and mop sink drain. CONCLUSIONS The three cases of P. aeruginosa bloodstream infections in leukemia patients cannot be judged as the outbreak of hospital infection.