University of Maryland, School of Medicine, Baltimore, MD 21201, USA.
Am J Infect Control. 2011 Nov;39(9):711-5. doi: 10.1016/j.ajic.2010.09.005.
Multidrug-resistant (MDR) Acinetobacter baumannii (MDR-AB) is an important nosocomial pathogen associated with significant morbidity and mortality.
We conducted a prospective cohort study of intensive care unit patients colonized or infected with MDR-AB at a tertiary care hospital from October 2008 to January 2009. For each patient, 10 surfaces in the patient room were sampled and evaluated for the presence of A baumannii. Pulsed-field gel electrophoresis was performed on all environmental isolates and a clinical isolate if available.
Fifty rooms were sampled; 48% (24/50) were positive at 1 or more environmental sites. Supply carts (10/50, 20%), floors (8/50, 16%), infusion pumps (7/50, 14%), and ventilator touch pads (5/44, 11.4%) were most commonly contaminated. Patients with a recent history of MDR-AB were no more likely to contaminate their environment than patients with a remote history (51% vs 36%, respectively, P value = .50). In 85% (17/20) of cases, the environmental isolate was classified as genetically similar to the patient isolate.
For patients with MDR-AB, the surrounding environment is frequently contaminated, even among patients with a remote history of MDR-AB. Surfaces often touched by health care workers during routine patient care are commonly contaminated and may be a source of nosocomial spread.
多重耐药（MDR）鲍曼不动杆菌（MDR-AB）是一种重要的医院获得性病原体，与较高的发病率和死亡率相关。
我们在 2008 年 10 月至 2009 年 1 月期间对一家三级医院的重症监护病房中定植或感染 MDR-AB 的患者进行了一项前瞻性队列研究。对于每位患者，采集 10 个病房内表面样本，以评估是否存在鲍曼不动杆菌。对所有环境分离株和临床分离株（如果有）进行脉冲场凝胶电泳分析。
共采集了 50 个房间的样本；有 48%（24/50）在 1 个或多个环境部位呈阳性。污染最严重的物品包括供应推车（10/50，20%）、地板（8/50，16%）、输液泵（7/50，14%）和呼吸机触摸垫（5/44，11.4%）。近期有 MDR-AB 病史的患者比有远程 MDR-AB 病史的患者更有可能污染其环境（分别为 51%和 36%，P 值=.50）。在 85%（17/20）的情况下，环境分离株被归类为与患者分离株在遗传上相似。
对于 MDR-AB 患者，周围环境经常受到污染，即使是在有远程 MDR-AB 病史的患者中也是如此。在日常护理过程中经常被医护人员触摸的表面通常受到污染，可能是医院内传播的来源。
