新生儿重症监护病房的细菌污染：新生儿有多安全？
Bacterial contamination of neonatal intensive care units: How safe are the neonates?
机构信息
Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal.
Department of Pediatrics and Neonatology, Manipal College of Medical Sciences, Pokhara, Nepal.
出版信息
Antimicrob Resist Infect Control. 2021 Jan 30;10(1):26. doi: 10.1186/s13756-021-00901-2.
BACKGROUND
Intensive care units (ICU) are essential healthcare facility for life threatening conditions. Bacterial contamination of objects/instruments in ICU is an important source of nosocomial infections. This study is aimed to determine the level of bacterial contamination of instruments/objects which are commonly touched by healthcare workers and frequently come in contact with the neonates.
METHODS
This hospital based prospective study was conducted in neonatal intensive care unit (NICU) of Manipal Teaching Hospital, Pokhara, Nepal. A total of 146 samples collected from surfaces of incubators, radiant warmers, suction tips, ventilators, stethoscopes, door handles, weighing machines, mothers' beds, phototherapy beds, laryngoscope, telephone sets, blood pressure machine, etc. formed the material of the study. Isolation, identification and antibiotic susceptibility of the bacterial isolates was performed by standard techniques. Blood culture isolates from NICU patients during the study period were compared with the environmental isolates.
RESULTS
Out of 146 samples, bacterial growth was observed in 109. A total of 119 bacterial isolates were retrieved from 109 samples. Three common potential pathogens isolated were Escherichia coli (n = 27), Klebsiella species (n = 21) and Staphylococcus aureus (n = 18). Majority of E. coli and Klebsiella isolates were from incubators, suction tips and mothers' beds. Majority of S. aureus isolates were cultured from radiant warmers. Among S. aureus isolates, 33.3% (6/18) were methicillin resistant. Majority of the bacterial isolates were susceptible to gentamicin and amikacin. Common potential pathogens isolated from blood culture of NICU patients were S. aureus and Klebsiella species.
CONCLUSION
High degree of bacterial contamination of objects/instruments in NICU was recorded. Isolation of potential pathogens like E. coli, Klebsiella species and S. aureus is a major threat of nosocomial infections. Blood culture data of NICU reflects possibility of nosocomial infections from contaminated sites. Gentamicin and amikacin may be used for empirical therapy in suspected cases of nosocomial infections in NICU.
背景
重症监护病房（ICU）是治疗危及生命疾病的重要医疗机构。ICU 中物体/器械的细菌污染是医院感染的重要来源。本研究旨在确定医护人员经常接触且经常与新生儿接触的器械/物体的细菌污染程度。
方法
这是一项在尼泊尔博克拉的马纳帕尔教学医院新生儿重症监护病房（NICU）进行的基于医院的前瞻性研究。共从婴儿保温箱、辐射保暖器、吸引管、呼吸机、听诊器、门把手、体重秤、产妇床、光疗床、喉镜、电话、血压计等表面采集了 146 个样本。采用标准技术对细菌分离株进行分离、鉴定和抗生素药敏试验。比较了研究期间 NICU 患者的血培养分离株与环境分离株。
结果
在 146 个样本中，有 109 个样本观察到细菌生长。从 109 个样本中提取了 119 个细菌分离株。从三个常见的潜在病原体中分离出 119 个细菌分离株，分别为大肠杆菌（n=27）、克雷伯菌属（n=21）和金黄色葡萄球菌（n=18）。大多数大肠杆菌和克雷伯菌分离株来自保温箱、吸引管和产妇床。大多数金黄色葡萄球菌分离株来自辐射保暖器。在金黄色葡萄球菌分离株中，33.3%（6/18）为耐甲氧西林金黄色葡萄球菌。大多数细菌分离株对庆大霉素和阿米卡星敏感。从 NICU 患者血培养中分离出的常见潜在病原体为金黄色葡萄球菌和克雷伯菌属。
结论
NICU 中物体/器械的细菌污染程度很高。分离出大肠杆菌、克雷伯菌属和金黄色葡萄球菌等潜在病原体是医院感染的主要威胁。NICU 的血培养数据反映了污染部位可能发生的医院感染。在疑似 NICU 医院感染的情况下，庆大霉素和阿米卡星可能用于经验性治疗。
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