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秘鲁儿科和新生儿重症监护病房医护人员手机中产超广谱β-内酰胺酶肠杆菌科细菌

Extended-spectrum β-lactamase-producing Enterobacteriaceae in cell phones of health care workers from Peruvian pediatric and neonatal intensive care units.

作者信息

Loyola Steev, Gutierrez Luz R, Horna Gertrudis, Petersen Kyle, Agapito Juan, Osada Jorge, Rios Paul, Lescano Andres G, Tamariz Jesus

机构信息

Universidad Peruana Cayetano Heredia, Lima, Peru; U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru.

Universidad Peruana Cayetano Heredia, Lima, Peru.

出版信息

Am J Infect Control. 2016 Aug 1;44(8):910-6. doi: 10.1016/j.ajic.2016.02.020. Epub 2016 Apr 7.

Abstract

BACKGROUND

Health care workers (HCWs) use their mobile phones during working hours or medical care. There is evidence that the instruments are colonized with pathogenic microorganisms. Here, we describe levels of Enterobacteriaceae contamination (EC) in cell phones and the risk factors associated with EC in Peruvian intensive care units (ICUs).

METHODS

This was a 5-month cohort study among 114 HCWs of 3 pediatric and 2 neonatology ICUs from 3 Peruvian hospitals. A baseline survey collected data on risk factors associated with EC. Swabs were collected from HCWs' phones every other week.

RESULTS

Three-quarters of HCWs never decontaminated their phones, and 47% reported using the phones in the ICU >5 times while working. EC was frequent across samplings and sites and was substantially higher in subjects with longer follow-up. Potential risk factors identified did not have strong associations with positive samples (relative risk, 0.7-1.5), regardless of significance. Half of the phones were colonized with an Enterobacteriaceae at least once during the 4 samplings attained on average during the study period. Half of the isolates were multidrug resistant (MDR), and 33% were extended-spectrum β-lactamase producers.

CONCLUSIONS

EC on HCWs' phones was frequent and apparently randomly distributed through the hospitals without clear clustering or strongly associated risk factors for having a positive sample. Based on the level of EC, phones may be considered as potential bacterial reservoirs of MDR and ESBL bacteria.

摘要

背景

医护人员在工作时间或医疗护理过程中会使用手机。有证据表明这些器械被致病微生物定植。在此,我们描述了秘鲁重症监护病房(ICU)中手机上肠杆菌科细菌污染(EC)的水平以及与EC相关的风险因素。

方法

这是一项针对秘鲁3家医院3个儿科ICU和2个新生儿ICU的114名医护人员进行的为期5个月的队列研究。一项基线调查收集了与EC相关的风险因素数据。每隔一周从医护人员的手机上采集拭子。

结果

四分之三的医护人员从未对手机进行过消毒,47%的人报告在ICU工作时使用手机超过5次。在各个采样点和时间段,EC都很常见,且随访时间较长的受试者中EC水平显著更高。所确定的潜在风险因素与阳性样本之间没有很强的关联(相对风险,0.7 - 1.5),无论其是否具有统计学意义。在研究期间平均进行的4次采样中,一半的手机至少有一次被肠杆菌科细菌定植。一半的分离株具有多重耐药性(MDR),33%是超广谱β-内酰胺酶产生菌。

结论

医护人员手机上的EC很常见,且在医院中显然是随机分布的,没有明显的聚集现象或与阳性样本有强关联的风险因素。基于EC水平,手机可能被视为MDR和ESBL细菌的潜在细菌储存库。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5d9/5253370/6b48b2b68992/nihms842142f1.jpg

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