碳青霉烯类药物不敏感克雷伯菌院内感染调查报告

Investigation on nosocomial infection of carbapenem-nonsusceptible Klebsiella pneumoniae

目的调查分析碳青霉烯类药物不敏感肺炎克雷伯菌院内感染原因,制订措施降低院内感染率。方法采用回顾性分析和前瞻性调查相结合的方法,选取10例对碳青霉烯类药物不敏感肺炎克雷伯菌阳性的住院患儿,依据其临床症状、细菌耐药检测结果、入院时检验结果等进行详细流行病学调查。结果 10例住院患儿中4例排除碳青霉烯类药物不敏感肺炎克雷伯菌感染,分析原因可能存在样本污染;4例确诊为对碳青霉烯类药物不敏感肺炎克雷伯菌感染,其中2例为院内感染、2例排除院内感染;另有2例不能明确诊断为对碳青霉烯类药物不敏感肺炎克雷伯菌感染。结论碳青霉烯类药物不敏感肺炎克雷伯菌是引起院内感染的重要致病菌,应对其引起医院的足够重视。应坚持检验与调查相结合,寻根溯源,注重各接触环节隔离消毒,加强工作人员培训,提高院内感染控制意识。

Objective To investigate the reason of nosocomial infection for carbapenem-nonsusceptible Klebsiella pneumoniae, and develop measures to reduce nosocomial infection. Methods Adopting the combination method of retrospective analysis and prospective investigation, 10 cases of hospitalized children with carbapenem-nonsusceptible Klebsiella pneumoniae were chosen and done a detailed epidemiological investigation on the basis of clinical symptoms, bacterial drug resistance test results, test results on admission, etc. Results 4 cases were excluded from the infection of carbapenem-nonsusceptible Klebsiella pneumoniae with the possible cause of sample contamination; 4 cases were diagnosed to be infected with carbapenem-nonsusceptible Klebsiella pneumoniae with 2 cases of nosocomial infection and 2cases excluded from nosocomial infection; another 2 cases could not be diagnosed to be infected with carbapenem-nonsusceptible Klebsiella pneumoniae. Conclusion We should adhere to the combination of inspection and investigation, pay attention to the isolation and disinfection of each contact link, strengthen the training of staff, improve the awareness of nosocomial infection control.