Department of Bacteriology 2, National Institute of Infectious Diseases, Tokyo, Japan.
J Hosp Infect. 2011 Aug;78(4):317-22. doi: 10.1016/j.jhin.2011.04.013.
An outbreak of multidrug-resistant (MDR) Pseudomonas aeruginosa occurred in an acute care hospital in Japan, which lasted for more than three years. During January 2006 to June 2009, 59 hospitalised patients with MDR P. aeruginosa were mainly detected by urine culture in the first half, whereas isolation from respiratory tract samples became dominant in the latter half of the outbreak. Non-duplicate MDR P. aeruginosa isolates were available from 51 patients and all isolates were positive for bla(VIM-2). Pulsed-field gel electrophoresis (PFGE) analysis categorised the isolates into three major clusters; types A, B and C with eight, 19 and 21 isolates, respectively. The outbreak started with patients harbouring PFGE type A strains, followed by type B, and type C strains. Multivariate analysis demonstrated that patients with PFGE type C strains were more likely to be detected by respiratory tract samples (odds ratio: 11.87; 95% confidence interval: 1.21-116.86). Improved aseptic urethral catheter care controlled PFGE type A and type B strains and improvement in respiratory care procedures finally contained the transmission of PFGE type C strains.
日本一家急性护理医院发生了一场持续三年多的多重耐药（MDR）铜绿假单胞菌爆发。2006 年 1 月至 2009 年 6 月，59 名住院患者主要通过尿液培养检测到 MDR 铜绿假单胞菌，而在爆发的后半段，呼吸道样本的分离成为主导。从 51 名患者中获得了非重复的 MDR 铜绿假单胞菌分离株，所有分离株均对 bla(VIM-2)呈阳性。脉冲场凝胶电泳（PFGE）分析将分离株分为三个主要簇；A、B 和 C 型，分别有 8、19 和 21 个分离株。爆发始于携带 PFGE 型 A 菌株的患者，随后是 B 型和 C 型菌株。多变量分析表明，携带 PFGE 型 C 菌株的患者更有可能通过呼吸道样本检测到（比值比：11.87；95%置信区间：1.21-116.86）。改进的无菌尿道导管护理控制了 PFGE 型 A 和 B 菌株的传播，改进的呼吸道护理程序最终遏制了 PFGE 型 C 菌株的传播。
