产超广谱β-内酰胺酶肺炎克雷伯菌感染新生儿重症监护病房。
Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a neonatal intensive care unit.
机构信息
Department of Infection Control, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
出版信息
World J Pediatr. 2012 Aug;8(3):268-71. doi: 10.1007/s12519-012-0370-4. Epub 2012 Aug 12.
BACKGROUND
A molecular epidemiological survey was conducted on an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBLKp) infection in our neonatal intensive care unit (NICU) from February to June 2008.
METHODS
Cultures of clinical samples from neonates in the NICU, the hands of healthcare workers and the environment of the NICU were subjected to ESBLKp isolation. Pulsed-field gel electrophoresis was performed to determine Klebsiella pneumoniae strains (type A-D).
RESULTS
In 1439 neonates, 38 (2.6%) had infections and 65 (4.5%) had colonizations with ESBLKp. Microbiological sampling of the NICU environment yielded 33 (14.9%) ESBLKp isolates from 222 samples. Clone A was found in 88.2% of the infected neonates, 66.7% of the colonized neonates, 69.7% of the environmental samples, and the hands of a healthcare worker.
CONCLUSIONS
The detection rate of ESBLKp is high in environmental samples, especially those from frequently touched surfaces. Since ESBLKp was identified on the hands of a healthcare worker in the present study, hand and environmental hygiene is mandatory for infection control in neonatal intensive care units.
背景
2008 年 2 月至 6 月，我们对新生儿重症监护病房（NICU）中广泛耐药型肠杆菌科细菌（ESBLKp）感染进行了分子流行病学调查。
方法
对 NICU 新生儿的临床标本、医护人员的手和 NICU 的环境进行 ESBLKp 分离培养。采用脉冲场凝胶电泳确定肺炎克雷伯菌菌株（A-D 型）。
结果
在 1439 例新生儿中，有 38 例（2.6%）发生感染，有 65 例（4.5%）定植 ESBLKp。对 NICU 环境进行微生物采样，从 222 份标本中获得 33 株（14.9%）ESBLKp 分离株。感染新生儿中有 88.2%、定植新生儿中有 66.7%、环境样本中有 69.7%、以及一名医护人员的手上发现了 A 型克隆。
结论
环境样本中 ESBLKp 的检出率较高，尤其是经常接触的表面样本。由于本研究在一名医护人员的手上发现了 ESBLKp，因此，新生儿重症监护病房必须进行手卫生和环境清洁，以控制感染。
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