NICU肺炎克雷伯菌医院感染的病房环境传播特征研究

Environmental propagation characteristics of nosocomial infection with Klebsiella pneumoniae of patients in NICU

目的明确肺炎克雷伯菌(KP)在神经危重症监护病房(NICU)环境中的传播特征,为制定NICU的病房环境消毒和KP感染的预防和控制方案提供依据。方法监测医院2015年1月-2016年12月NICU的KP感染患者54例及病房环境中的KP定植情况,应用脉冲场凝胶电泳实验(PFGE)对KP菌株间的同源性进行分析。结果两年间共检出非重复性KP 63株,其中患者感染病原菌54株,病房环境检出KP定植菌株9株,成功分型61株,分为49个型别,其中菌株数量多于1株且相似度达100%的同一克隆株共10株。结论 KP可长时间定植生存于NICU病房环境中成为隐匿感染源引发医院感染的传播,在病原菌和病房环境监测的指导下进行病房环境的有效消毒是防控KP感染的重要措施。

OBJECTIVE To identify the propagation characteristics of Klebsiella pneumoniae（KP）in the neurological intensive care unit（NICU）ward environment,so as to provide basis for the establishment of disinfection project of NICU ward environment and the prevention and control of KP infection.METHODS A total of 54 KP-infected patients and the colonization of KP in the ward environment of NICU from Jan.2015 to Oct.2016 were monitored.Pulsed-field gel electrophoresis was used to analyze the homology of isolated KP strains.RESULTS A total of 63 non-repetitive KP were detected within two years,including 54 KP strains isolated from infected patients and 9 KP strains detected from the infected environmental monitoring,of which 61 KP isolates were successfully genotyped and divided into 49 types.There were 10 groups,where the same clone type involved more than one strains with 100% similarity.CONCLUSION KP can survive and colonize in NICU ward environment,thus becoming an occult source of infection which leads to transmission.The effective disinfection of the ward environment is an important measure to prevent and control KP infection,which has to be adopted under the guidance of pathogenic bacteria and ward environmental monitoring.