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重症监护病房鲍曼不动杆菌暴发的调查与管理

Investigation and management of an A. Baumannii outbreak in ICU.

作者信息

Adams Debra, Yee Lian, Rimmer Jo-Anne, Williams Ruth, Martin Helen, Ovington Colin

机构信息

Infection Prevention and Control.

出版信息

Br J Nurs. 2011;20(3):140, 142,144-7. doi: 10.12968/bjon.2011.20.3.140.

Abstract

Acinetobacter baumannii infection is responsible for a wide range of infections, including pneumonia, bacteraemia, meningitis, wound infections, and urinary tract infections. During June 2010, two patients on an intensive care unit in an acute hospital in the UK had multi-resistant A. baumannii identified in samples obtained from a variety of specimens. A further case was identified 31 days following confirmation of the first outbreak. The investigation and management of this outbreak included the introduction of enhanced infection prevention and control precautions; the establishment of an Outbreak Control Team; epidemiological investigations; and the decontamination of equipment and the environment. Isolate typing by the Health Protection Agency Centre for Infections laboratory confirmed the three cases had identical A. baumannii strains: European clone II lineage encoded with an OXA-51-type carbapenemase. This suggests that there was a patient-to-patient spread of multi-resistant A. baumannii.

摘要

鲍曼不动杆菌感染可引发多种感染,包括肺炎、菌血症、脑膜炎、伤口感染和尿路感染。2010年6月期间,英国一家急症医院重症监护病房的两名患者,在从各种标本获取的样本中检测出多重耐药鲍曼不动杆菌。在首次暴发确诊31天后又发现了另一例病例。此次暴发的调查和管理工作包括加强感染预防与控制措施;成立疫情控制小组;进行流行病学调查;以及对设备和环境进行消毒。英国卫生防护局感染中心实验室的菌株分型证实,这三例病例感染的鲍曼不动杆菌菌株相同:欧洲克隆II谱系,编码OXA-51型碳青霉烯酶。这表明多重耐药鲍曼不动杆菌存在患者之间的传播。

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