新生儿重症监护病房发生的为期六个月的粘质沙雷氏菌疫情。
A six-month Serratia marcescens outbreak in a Neonatal Intensive Care Unit.
作者信息
Morillo Áurea, González Verónica, Aguayo Josefa, Carreño Concepción, Torres María José, Jarana Daniel, Artacho María José, Jiménez Francisco, Conde Manuel, Aznar Javier
机构信息
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, CSIC, Universidad de Sevilla, Sevilla, Spain.
出版信息
Enferm Infecc Microbiol Clin. 2016 Dec;34(10):645-651. doi: 10.1016/j.eimc.2016.01.006. Epub 2016 Feb 18.
OBJECTIVE
To investigate a Serratia marcescens (S. marcescens) outbreak in a Neonatal Unit in a tertiary university hospital.
METHODS
Descriptive study of children admitted to the Unit with S. marcescens infection from November 2012 to March 2013. Conventional microbiological methods for clinical and environmental samples were used. The clonal relationship between all available isolates was established by molecular methods. A multidisciplinary team was formed, and preventive measures were taken.
RESULTS
S. marcescens was isolated from 18 children. The overall attack rate was 12%, and the case fatality rate in the Intensive Care Unit was 23.5%. The most prevalent types of infections were pneumonia (6), conjunctivitis (6), and bloodstream infection (5). Clinical isolates and environmental isolates obtained from an incubator belonged to a unique clone. The clonal relationship between all S. marcescens strains helped us to identify the possible source of the outbreak.
CONCLUSION
Isolation of S. marcescens from stored water in a container, and from the surface of an incubator after cleaning, suggests a possible environmental source as the outbreak origin, which has been perpetuated due to a failure of cleaning methods in the Unit. The strict hygiene and cleaning measures were the main factors that contributed to the end of the outbreak.
目的
调查一所三级大学医院新生儿病房发生的粘质沙雷氏菌暴发情况。
方法
对2012年11月至2013年3月入住该病房且感染粘质沙雷氏菌的儿童进行描述性研究。对临床和环境样本采用常规微生物学方法。通过分子方法确定所有可用分离株之间的克隆关系。组建了一个多学科团队并采取了预防措施。
结果
从18名儿童中分离出粘质沙雷氏菌。总体发病率为12%，重症监护病房的病死率为23.5%。最常见的感染类型为肺炎（6例）、结膜炎（6例）和血流感染（5例）。从一台培养箱获得的临床分离株和环境分离株属于一个独特的克隆。所有粘质沙雷氏菌菌株之间的克隆关系帮助我们确定了此次暴发的可能源头。
结论
从一个容器中的储存水以及清洁后的培养箱表面分离出粘质沙雷氏菌，表明环境可能是此次暴发的源头，而该病房清洁方法的失效导致了疫情的持续。严格的卫生和清洁措施是促成疫情结束的主要因素。
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