Chetchotisakd P, Phelps C L, Hartstein A I
Department of Medicine, Indiana University Medical Center, Indianapolis.
Clin Infect Dis. 1994 Jun;18(6):929-37. doi: 10.1093/clinids/18.6.929.
The prevalence of possible cross-transmission of selected bacteria (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Staphylococcus aureus, and enterococci) among infected patients was evaluated in five intensive care units (ICUs) over 6 months. A total of 284 isolates from clinical specimens were typed by plasmid profile analysis (E. coli, K. pneumoniae, and E. cloacae), restriction endonuclease analysis of plasmid DNA (S. aureus), and/or pulse-field gel electrophoresis of chromosomal DNA (P. aeruginosa, enterococci, S. aureus, and other bacteria without plasmid DNA). By typing criteria, only 13% of the 177 isolates obtained after > 2 days in an ICU were classified as possibly cross-transmitted. Many patients whose cultures yielded bacteria of an identical type may have been the sources rather than the recipients of these organisms. Episodes of possible cross-transmission were scattered among all ICUs, usually affected only two patients, and were associated with most bacterial species. These data suggest that endemic bacterial cross-transmission in ICUs is relatively infrequent and that cross-transmitted bacteria are not common causes of endemic ICU-related nosocomial infections.
在6个月的时间里，对5个重症监护病房（ICU）中感染患者之间选定细菌（大肠杆菌、肺炎克雷伯菌、阴沟肠杆菌、铜绿假单胞菌、金黄色葡萄球菌和肠球菌）的可能交叉传播情况进行了评估。通过质粒图谱分析（用于大肠杆菌、肺炎克雷伯菌和阴沟肠杆菌）、质粒DNA的限制性内切酶分析（用于金黄色葡萄球菌）和/或染色体DNA的脉冲场凝胶电泳（用于铜绿假单胞菌、肠球菌、金黄色葡萄球菌和其他无质粒DNA的细菌），对从临床标本中分离出的284株菌株进行了分型。根据分型标准，在ICU住院超过2天的177株分离株中，只有13%被归类为可能发生了交叉传播。许多培养出相同类型细菌的患者可能是这些微生物的来源而非接受者。可能的交叉传播事件分散在所有ICU中，通常仅影响两名患者，并且与大多数细菌种类有关。这些数据表明，ICU中的地方性细菌交叉传播相对较少，并且交叉传播的细菌并非地方性ICU相关医院感染的常见原因。
