NICU嗜麦芽寡养单胞菌医院感染暴发的调查

Outbreak of Stenotrophomonas maltophilia infections in NICU:an epidemiological study

目的对新生儿重症监护病房(NICU)短期内出现的3例嗜麦芽寡养单胞菌感染患儿,进行流行病学调查分析,为预防与控制医院感染暴发提供参考资料。方法对2010年10月25-28日NICU出现的3例医院感染嗜麦芽寡养单胞菌的患者进行流行病学调查,采集环境卫生标本进行检验,分析感染的原因。结果 3例嗜麦芽寡养单胞菌感染病例有2种耐药谱;3株嗜麦芽寡养单胞菌仅对环丙沙星、左氧氟沙星及磺胺甲噁唑/甲氧苄啶耐药率为0,对其他抗菌药物均出现不同程度的耐药现象;医务人员手、空气、呼吸机管道等标本中均未检出嗜麦芽寡养单胞菌。结论该次嗜麦芽寡养单胞菌感染为局部疑似感染暴发;广谱抗菌药物美罗培南对嗜麦芽寡养单胞菌筛选可能是此次感染的主要原因,合理使用抗菌药物对预防医院感染至关重要。

OBJECTIVE To find out the epidemiological features of Stenotrophornonas rnaltophilia outbreak in NICU to prevent and treat this nosoeomial infection. METHODS The case histories from 3 inpatients who developed S. maltophilia infection in NICU from Oct 25 to 28, 2010, were studied retrospectively and the environmental health specimens were tested to find out the reasons of infection and treatment measures. RESULTS 3 cases of S. maltophilia infection had two sensitivity spectrum. Drug sensitivity test indicated that the resistance rates of 3 strains S. rnaltophilia to ciprofloxacin, sulfamethoxazole/trimethoprim and levofloxacin were 0, and showed different levels of drug resistance to other antibiotics. The S. maltophilia was not found in medical staff hands, air and artificial ventilator pipes, etc. CONCLUSIONS The infection is a suspected outbreak of S. rnalto- philia infection. The main reasons of the infection are the using of broad-spectrum antibiotic （meropenem） and artificial ventilation devices. Rational use of antibiotics is essential to prevent nosocomial infection.