6例危重症患者脑膜脓毒性伊丽莎白菌聚集性感染案例调查

Investigation on 6 critical patients with cluster infection of Elizabethkingia meningoseptica

目的调查某医院神经外科监护室6例危重症患者脑膜脓毒性伊丽莎白菌(EM)聚集性感染的原因。方法回顾性调查该院神经外科ICU的6例呼吸道痰液标本EM阳性患者,对患者临床资料,所在环境、物品表面和医护手细菌检测,并对耐药性鉴定结果进行分析。结果6例患者呼吸道细菌标本检测出的EM药敏谱相似,采集189份环境细菌培养标本,19份EM菌落>500 cfu/cm^(2),按照《医院消毒卫生标准》判定为严重不合格,其中医护、护工手皿26份,不合格7份;呼吸机物体表面、出风口、冷凝水共39份,不合格3份;患者生活用品共20份,不合格3份;环境物体表面共104份,不合格6份。结论不规范的手卫生,不严格执行消毒隔离制度,是此次重症患者聚集性感染的主要原因。

Objective To find out the cause of 6 critical patients with cluster infection of Elizabethkingia meningoseptica(EM)in neurosurgical intensive care(NICU)unit.Methods Retrospectively investigation was used to survey 6 patients with positive EM collected from respiratory sputum specimens in NICU,and the clinical data,environment,surfaces,bacterial detection and drug resistance identification results were analyzed.Results The drug susceptibility spectrum was similar among the specimens of respiratory tract bacteria from 6 patients.19 out of 189 environment samples(EM colony>500 cfu/cm^(2))were judged to be unqualified according to the“standard of hospital disinfection health”of the classⅡenvironment health standard for hospital disinfection normal index.Among them,7 out of 26 hand dishes from medical and nursing workers were unqualified;3 out of 39 surface,air outlet and condensed water of the ventilator were unqualified;3 out of 20 daily necessities from patients were unqualified;6 out of 104 environmental surface were unqualified.Conclusion The main causes of 6 critical patients with cluster infection of EM in NICU are poor hand hygiene and no strictly implementing disinfection and isolation.