Wang S H, Sheng W H, Chang Y Y, Wang L H, Lin H C, Chen M L, Pan H J, Ko W J, Chang S C, Lin F Y
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
J Hosp Infect. 2003 Feb;53(2):97-102. doi: 10.1053/jhin.2002.1348.
Acinetobacter baumannii is ubiquitous and has recently become one of the most important healthcare-associated (HA) pathogens in hospitals. Infection caused by this organism often leads to significant morbidity and mortality. Outbreaks of pan-drug resistant Acinetobacter baumannii (PDRAB) have rarely been reported. During a two-month period, an outbreak of PDRAB colonization and infection affecting 7 patients occurred in our surgical intensive care unit (SICU). The colonized sites were respiratory tract (N = 7) and central venous catheter (N = 2). One of the patients had a surgical wound infection. Extensive environmental contamination was identified, including sites such as bed rails, bedside tables, surface of ventilators and infusion pump, water for nasogastric feeding and ventilator rinsing and sinks. All of the isolates were analysed by pulsed-field gel electrophoresis (PFGE) and showed an identical pattern. After use of strict cohort nursing, hand hygiene environmental cleaning, and replacement of a dysfunctional high-efficiency particulate air filter (HEPA), the outbreak was controlled.
鲍曼不动杆菌广泛存在,最近已成为医院中最重要的医疗保健相关(HA)病原体之一。该病原体引起的感染常导致显著的发病率和死亡率。泛耐药鲍曼不动杆菌(PDRAB)暴发的报道很少。在两个月的时间里,我们的外科重症监护病房(SICU)发生了一起影响7例患者的PDRAB定植和感染暴发。定植部位为呼吸道(7例)和中心静脉导管(2例)。其中1例患者发生手术伤口感染。发现存在广泛的环境污染,包括床栏、床头柜、呼吸机表面、输液泵、鼻饲用水、呼吸机冲洗用水和水槽等部位。所有分离株均通过脉冲场凝胶电泳(PFGE)分析,显示出相同的图谱。在采取严格的分组护理、手部卫生、环境清洁以及更换功能失调的高效空气过滤器(HEPA)后,疫情得到了控制。