NICU营养液污染导致鲍氏不动杆菌聚集性病例调查分析

Survey on a clustering case with multidrug-resistant Acinetobacter baumannii caused by nutrient admixture contamination in neonatal intensive care unit (NICU)

目的调查某院新生儿重症监护室(NICU)发生的多药耐药鲍氏不动杆菌聚集性病例发生的原因,为临床治疗提供参考依据。方法采用前瞻性和回顾性调查方法对2013年5月该院发生2例血流感染多药耐药鲍氏不动杆菌患儿进行流行病学调查。结果 2例患儿血培养分离鲍氏不动杆菌,对庆大霉素、妥布霉素、环丙沙星、左氧氟沙星和磺胺甲噁唑/甲氧苄啶敏感;2例患儿经治疗好转后转出NICU;共采集环境相关样本11份,其中从2例患儿输注剩余营养液中分离到鲍氏不动杆菌,且与患儿血标本分离的鲍氏不动杆菌耐药谱一致。结论此次NICU多药耐药鲍氏不动杆菌聚集性病例是由营养液污染引起的输注后患儿血流感染。

OBJECTIVE To investigate the causes of a clustering case with multidrug-resistant Acinetobacter baumannii（MDR-Ab）in neonatal intensive care unit（NICU）,so as to provide references for clinical treatment.METHODS By combination of prospective and retrospective investigation,2cases of children patients who were infected with MDR-Ab bloodstream infection in May 2013 were performed epidemiological study.RESULTS Ab isolated from 2children patients＇ blood were sensitive to gentamycin,tobramycin,ciprofloxacin,levofloxacin and sulfamethoxazole/trimethoprim.Both children patients were recovered after therapy.A total of 11 cases of environmental specimens were taken,and Ab were isolated from 2specimens taken from the rest of nutrient admixture used by these 2children patients,which had the same antimicrobial resistant pattern with their blood culture.CONCLUSION The clustering case of MDR-Ab bloodstream infection in NICU is related to the contamination of nutrient admixture.