妇科患者腹腔镜术后切口龟分枝杆菌感染暴发调查

Outbreak of Mycobacterium chelonae infection after laparoscopic surgery in department of gynecology

目的对妇科患者发生的龟分枝杆菌医院感染暴发进行调查,分析传染源和传播途径,为预防与控制医院感染提供参考。方法 2009年5月11日-7月22日通过查阅病历资料,了解患者感染状况;调查、记录腹腔镜专用低温灭菌器灭菌处理的全过程;现场采集腹腔镜、低温灭菌器、科室环境及感染患者手术切口分泌物标本,进行细菌学培养和鉴定。结果 36例行腹腔镜手术患者中13例发生手术切口感染,感染率为36.11%;其中有8例手术切口感染患者龟分枝杆菌培养阳性,占61.54%;8份低温灭菌器的采样标本中7份培养有龟分枝杆菌生长,阳性率为87.50%。结论该次医院感染暴发是由腹腔镜专用低温灭菌器灭菌无效,引起的腹腔镜术后切口龟分枝杆菌感染。

OBJECTIVE To investigate the outbreak of hospital infection caused by Mycobacterium chelonae in the department of gynecology ,trace the sources and transmission routes of the infection so as to provide reference for the prevention and control of hospital infection .METHODS The infection status of the patients was understood through review of medical records from May 11 to Jul .22 ,2009 .The whole process of low-temperature sterilizer for laparoscope was investigated and recorded . The samples from laparoscope , low-temperature sterilizer , departmental environment and secretion of the infected patients were collected on site for bacterial culture and identification .RESULTS Totally 13 cases had incision infected in the 39 patients who underwent laparoscopic surgery in the gynecology department and the infection rate was 36 .11% .Among them ,the samples from 8 cases of incision infection were detected as M .chelonae positive ,accounting for 61 .54% .Totally 7 out of 8 samples col-lected from the low-temperature sterilizer showed the growth of M .chelonae after cultivation ,and the positive rate was 87 .50% .CONCLUSIONS The outbreak of hospital infection is resulted from M .chelonae infection owing to ineffective sterilization by low-temperature sterilizer .