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耐碳青霉烯类鲍曼不动杆菌复合群在 COVID-19 重症监护病房的暴发控制。

Containment of a carbapenem-resistant Acinetobacter baumannii complex outbreak in a COVID-19 intensive care unit.

机构信息

Division of Infectious Diseases, Infection Control, Memorial Healthcare System, Hollywood, FL.

Infection Prevention, Memorial Hospital Miramar, Miramar, FL.

出版信息

Am J Infect Control. 2022 May;50(5):477-481. doi: 10.1016/j.ajic.2022.02.022. Epub 2022 Feb 26.

DOI:10.1016/j.ajic.2022.02.022
PMID:35227793
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8881223/
Abstract

BACKGROUND

A carbapenem-resistant Acinetobacter baumannii outbreak in the COVID intensive care unit of a community hospital was contained using multidrug resistant organism guidelines. The purpose of this study is to report on an outbreak investigation and containment strategy that was used, and to discuss prevention strategy.

METHODS

A multidisciplinary approach contained the spread of infection. Strategies implemented included consultation with experts, screening, and reversal of personal protective equipment conservation. Ensuring infection control best practices are maintained remain important efforts to reduce the spread of multidrug resistant organisms.

RESULTS

Five patients with carbapenem-resistant Acinetobacter baumannii were identified from routine clinical cultures within one week and one patient was identified from active surveillance cultures.

DISCUSSION

Personal protective equipment conservation, strategies to prevent health care personnel exposure, and patient surge staffing protocols may have increased the likelihood of multidrug resistant organism transmission. Environmental and behavioral infection control regulations with effective administrative guidance, active surveillance cultures, and antimicrobial stewardship are critical to prevent future outbreaks.

CONCLUSIONS

After outbreak containment strategies were implemented, no additional patients were identified with carbapenem-resistant Acinetobacter baumannii. Conventional infection prevention and control strategies were re-instituted. A multidisciplinary approach with continued focus on hand hygiene, environmental cleaning, and correct use of personal protective equipment needs to be put in place to successfully contain and prevent the spread of carbapenem resistant infections.

摘要

背景

社区医院 COVID 重症监护病房发生耐碳青霉烯类鲍曼不动杆菌爆发,采用多药耐药菌指南进行了控制。本研究旨在报告所采用的爆发调查和控制策略,并讨论预防策略。

方法

多学科方法控制了感染的传播。实施的策略包括咨询专家、筛查和逆转个人防护设备的节约。确保感染控制最佳实践的持续执行仍然是减少多药耐药菌传播的重要努力。

结果

在一周内从常规临床培养物中发现了五例耐碳青霉烯类鲍曼不动杆菌患者,从主动监测培养物中发现了一例患者。

讨论

个人防护设备节约、预防医护人员暴露的策略以及患者激增人员配备协议可能增加了多药耐药菌传播的可能性。环境和行为感染控制法规以及有效的行政指导、主动监测培养物和抗菌药物管理对于预防未来的爆发至关重要。

结论

实施爆发控制策略后,未再发现耐碳青霉烯类鲍曼不动杆菌患者。重新实施了常规感染预防和控制策略。需要采用多学科方法,持续关注手卫生、环境清洁和正确使用个人防护设备,以成功控制和预防耐碳青霉烯类感染的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b8f/8881223/70d89d34df0b/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b8f/8881223/70d89d34df0b/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b8f/8881223/70d89d34df0b/gr1_lrg.jpg

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