摘要
目的调查医院新生儿重症监护病房(NICU)改建后一起由白假丝酵母菌引起的败血症感染暴发流行的原因,为有效控制医院感染提供科学依据。方法对2016年6月24日-7月15日医院新生儿病房白假丝酵母菌医院感染败血症患儿进行流行病学调查,并对医务人员手、病室环境及物表进行环境卫生学监测。结果 7例败血症患儿中4例给予有创呼吸机辅助通气,2例脐静脉置管,4例经外周静脉置管(PICC);7例双份血培养均为白假丝酵母菌,且药敏谱相同;环境卫生学采样,包括空气、工作人员手、物表等进行检测,合格率为54.55%,采取防控措施后再次采样检测,合格率为92.50%;2016年7月15日以后未再出现白假丝酵母菌败血症患儿,此次暴发事件得到有效的控制。结论此次医院感染暴发事件考虑新生儿病房改建后,消毒灭菌的呼吸机管路存放不当,通过医务人员置管操作传播;新生儿病房应加强呼吸机管路的管理,预防医院感染不良事件的发生。
OBJECTIVE To analyze the factors of a fungemia infectious outbreak caused by Candida albicans after neonatal intensive care unit（NICU）reconstruction,so as to provide scientific evidence for effective control of healthcare-associated infection（HAI）.METHODS Epidemiological investigation on patients with hospital-acquired septicemia caused by C.albicans from Jun.24 to Jul.15,2016,and environmental hygiene monitoring were performed including the staff hands,ward environment and object surface.RESULTS Among 7patients with HAI diagnosed sepsis,4cases used invasive ventilator,2cases used umbilical vein catheter,and 4cases used peripherally inserted central catheters（PICC）.All of 7double blood cultures were C.albicans,and had uniform drug-sensitivity spectrum.The qualified rate of environmental hygiene sampling including ward air,staff hands and object surface was 54.55%.After taking a series of controlling measures,the qualified rate was 92.50%.There was no fungemia case with C.albicans after Jul.15,2016,and this outbreak was effectively controlled.CONCLUSION This HAI outbreak may be caused by improper storage of disinfectant ventilator pipe after NICU reconstruction,and transmitted through intubation operation by health care workers.Management of ventilator pipe of NICU should be enhanced for preventing adverse events of HAI.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第8期1849-1851,共3页
Chinese Journal of Nosocomiology
关键词
病房改建
真菌败血症
医院感染
暴发
Ward reconstruction
Fungemia
Healthcare-associated infection
Outbreak
