一起洋葱伯克霍尔德菌医院感染调查

Investigation on one case of an nosocomial infection due to Burkholderia cepacia

目的对洋葱伯克霍尔德菌疑似暴发情况进行调查,分析可能的传染源和传播途径,为更好地预防和控制感染提供依据。方法选择2019年2月北京老年医院骨科病房洋葱伯克霍尔德菌感染患者6例为研究对象,采取患者血液标本,进行细菌检测与药敏试验,根据医院感染诊断标准、区域分布、时间、人群分布判断是否为感染暴发。同时采集环境标本及可能接触的医护人员手部细菌等标本进行检测查找传染源。结果6名患者血液中均分离出同一株病原体,为对头孢他啶、氯霉素、左氧氟沙星、磺胺甲噁唑/甲氧苄啶、美罗培南均敏感的洋葱伯克霍尔德菌。其余标本均未分离出洋葱伯克霍尔德菌。结论此次洋葱伯克霍尔德菌暴发可能为配液过程中污染所致。

OBJECTIVE To investigate the suspected outbreak of Burkholderia cepacia,analyze the possible source of infection and the transmission route,and provide a basis for better prevention and control of infection.METHODS A total of 6 patients with B.cepacia infection in the orthopedics ward of Beijing Geriatric Hospital in Feb.2019 were collected as research subjects.The specimens were collected for bacteria detection and drug sensitive tests.The outbreak was identified according to the hospital infection diagnostic criteria,regional distribution,time and population distribution.At the same time,the environmental samples and bacteria specimens that may be in contact with medical staff were also collected to detect the source of infection.RESULTS The same pathogen,B.cepacia,was isolated from all the blood samples of 6 patients.The strain was sensitive to ceftazidine,chloramphenicol,levofloxacin,trimoxazole and meropenem.B.onioniae was not isolated from other specimens.CONCLUSIONS The outbreak of B.onioniae may be caused by contamination in the preparation of intravenous fluids.