一起洋葱伯克霍尔德菌医院感染暴发的流行病学调查

Spidemiological survey of an outbreak of nosocomial infection caused by Burkholderia cepacia

目的调查某医院骨关节科洋葱伯克霍尔德菌医院感染暴发事件,为医院感染预防控制提供依据。方法对医院骨关节科收治的患者中,出现发热(体温≥38℃)伴寒颤者进行现场流行病学调查,对病例血标本进行细菌培养并进行脉冲场凝胶电泳(Pulsed field gel electrophoresis,PFGE)检测,利用卡方检验对罹患率进行比较分析,提出有效防控措施。结果2019年7月28-30日共发现8例医院感染病例,发病时间集中,均表现为寒颤和发热。其中4例病例血培养检出洋葱伯克霍尔德菌,PFGE检测分析,相似度为100.00%,为同种同源。病例留置针洗脱液中亦培养出该菌。结论该医院骨关节科发生一起由洋葱伯克霍尔德菌引起的医院感染暴发,可能与使用被污染的静脉推注药液和封管液有关。

OBJECTIVE To investigate the outbreak of Burkholderia cepacia infection in orthopedics and arthrology department of a hospital,and provide guidance for the prevention and control of nosocomial infection.METHODS Field epidemiological investigation was carried out in the patients admitted to the Department of Osteoarthritis of the hospital,who had fever(body temperature above 38 degrees)and chills.Blood samples were collected for bacterial culture and pulsed field gel electrophoresis(PFGE).Chi square test was used to compare the incidence of the disease,so as to provide effective prevention and control measures.RESULTS Eight nosocomial infection cases occurred from Jul.28 to Jul.30,2019,and the symptoms of all cases were fever and chills.Four strains of B.cepacia were separated from blood specimens of patients,with the identity of 100.00%by PFGE analysis,which showed the homologous.Bacteria were also cultured in the eluent of patients with detaining needle.CONCLUSION This was an outbreak of B.cepacia infection in orthopedics and arthrology department of a hospital.The infection was caused by intravenous medications and tube-sealing fluid contamination.