Peña C, Dominguez M A, Pujol M, Verdaguer R, Gudiol F, Ariza J
Infectious Disease Service and Microbiology Service, Hospital de Bellvitge, Universidad de Barcelona, C/Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Clin Microbiol Infect. 2003 Sep;9(9):938-43. doi: 10.1046/j.1469-0691.2003.00686.x.
To investigate an outbreak of carbapenem-resistant Pseudomonas aeruginosa (CRPA) in a urology ward.
Patients infected or colonized with CRPA were prospectively identified by daily laboratory surveillance. Routine infection-control measures were reinforced, disinfection protocols were revised, and a surveillance program was set up, analyzing cross-transmission in the nursing ward and environment cultures from urology wards and the operating theater. CRPA isolates from clinical and environment samples were studied by pulsed-field gel electrophoresis (PFGE), following XbaI and SpeI restriction.
From February 1998 to September 2000, 59 adult urology patients were colonized or infected by CRPA. All patients had been operated on prior to identification of the CRPA isolate and 79% of these procedures were performed in the same cystoscopy room. No patients had received prior carbapenem therapy. No cross-transmission was detected, and environment cultures from the urology ward and theater were negative except for five samples collected in the cystoscopy room. PFGE identified a single clone in the isolates from different patients and the environment samples.
The PFGE analysis indicated that the CRPA outbreak resulted from the contamination of the cystoscopy room via an unsealed drain. The outbreak ended when the drain was sealed.
调查泌尿外科病房耐碳青霉烯类铜绿假单胞菌（CRPA）的暴发情况。
通过每日实验室监测前瞻性地识别感染或定植CRPA的患者。加强常规感染控制措施，修订消毒方案，并建立监测计划，分析护理病房以及泌尿外科病房和手术室环境培养物中的交叉传播情况。对临床和环境样本中的CRPA分离株进行XbaI和SpeI酶切后的脉冲场凝胶电泳（PFGE）研究。
1998年2月至2000年9月，59名成年泌尿外科患者定植或感染了CRPA。所有患者在CRPA分离株鉴定之前均已接受手术，其中79%的手术在同一膀胱镜检查室进行。所有患者此前均未接受过碳青霉烯类治疗。未检测到交叉传播，泌尿外科病房和手术室的环境培养物均为阴性，但膀胱镜检查室采集的5份样本除外。PFGE在来自不同患者和环境样本的分离株中鉴定出单一克隆。
PFGE分析表明，CRPA暴发是由于膀胱镜检查室的排水管道未密封导致污染。排水管道密封后，暴发结束。
