重症监护病房多重耐药鲍曼不动杆菌暴发原因分析及防控对策

Analysis on breakout causes and control measures of multidrug-resistant Acinetobacter baumannii in intensive care unit

目的探讨重症监护病房(ICU)内多重耐药鲍曼不动杆菌(multidrug-resistant acinetobacter baumannii,MDRAB)感染暴发原因及防控对策。方法对ICU中32例MDRAB医院内感染进行流行病学调查分析并总结预防控制措施。结果室内环境、喉镜及呼吸机污染是引起ICU患者发生MDRAB感染暴发流行的主要原因。加强医务人员的手卫生,对病室环境及医疗器具等进行彻底消毒,切断外源性传播途径,是控制MDRAB医院内感染暴发、流行的有效措施。结论针对ICU内MDRAB感染暴发的主要原因,对ICU环境及物品进行定期、针对性消毒,合理应用抗生素,减少有创操作,特别是减少气管插管,严格遵照卫生部关于多重耐药菌的管理规范进行严格隔离及标准治疗,可有效控制MDRAB感染。

Objective To discuss the breakout causes and the control measures of muhidrug-resistant Acinetobacter baumannii （MDRAB） in intensive care unit（ICU）. Methods 32 patients with MDRAB nosocomial infection in ICU of this hospital were conducted the epidemiological investigation and analysis for summarizing the preventive and control measures. Resuits The indoor environment,laryngeal mirror pollution and breathing machine pollution were the main reasons causing MDRAB infection breakout. Strengthening the hands hygiene of medical personnel, carrying out thorough disinfection on indoor environment and medical appliance, and cutting off the exogenous route of transmission were the effective measures to control the MDRAB nosocomial infection and spread. Conclusion Aiming at the main reason~ of MDRAB infection breakout in ICU, disin- fecting the environment and materials in ICU regularly and pertinently, using the antibiotics ratinally, reducing the invasive opera- tion,especially the tracheal intubation,strictly complying with the management standard of muhidrug-resistant bacteria by the Ministry of Health to conduct the strict quarantine and standard treatment can effectively control the MDRAB infection.