Chandrashekar M R, Rathish K C, Nagesha C N
Department of Microbiology, Dr BR Ambedkar Medical College, Bangalore.
J Indian Med Assoc. 1997 Mar;95(3):72-4, 77.
A total of 256 swabs taken from different areas of neonatal intensive care units (ICU) in KCG Hospital and AMC Hospital, Bangalore were bacteriologically investigated for prevalence, source and spread of nosocomial bacteria. Culture studies revealed growth in 217 (84.8%) swab samples indicating considerable contamination of different areas of the units and sources of infection. Klebsiella pneumoniae (27.3%) was the predominant organism followed by Esch coli (16.8%), Staph aureus (11.7%), Staph epidermidis and Pseudomonas aeruginosa (10.2%), enterococcus and proteus (4.7%), Citrobacter freundi (3.5%) and Clostridium tetani (2.4%) isolated from the equipment, cradles, other inanimate objects and environmental surfaces. Out of 312 isolates, monobacterial prevalence was 43.6% in contrast to polybacterial prevalence of 56.4%. Klebsiella pneumoniae (74.3%) was the predominant monobacterial isolate. The indoor air of the units was found to carry common nosocomial bacteria of 4 or more different bacterial species at dangerous levels as observed by colony counts of 15 to 30 on exposed blood agar plates. Almost all sources in ICU revealed the presence of Klebsiella Pneumoniae, Esch coli, pseudomonas and staphylococcus thus forming the potential reservoirs of nosocomial infections to babies and this could be attributed to overcrowding, poor ventilation system and failure to follow basic principles of strict protective barrier nursing.
对班加罗尔KCG医院和AMC医院新生儿重症监护病房(ICU)不同区域采集的256份拭子进行了细菌学调查,以研究医院细菌的流行情况、来源和传播途径。培养研究显示,217份(84.8%)拭子样本有细菌生长,表明该病房不同区域和感染源存在相当程度的污染。肺炎克雷伯菌(27.3%)是主要菌株,其次是大肠杆菌(16.8%)、金黄色葡萄球菌(11.7%)、表皮葡萄球菌和铜绿假单胞菌(10.2%)、肠球菌和变形杆菌(4.7%)、弗氏柠檬酸杆菌(3.5%)以及从设备、婴儿床、其他无生命物体和环境表面分离出的破伤风梭菌(2.4%)。在312株分离菌株中,单一细菌感染率为43.6%,相比之下,多细菌感染率为56.4%。肺炎克雷伯菌(74.3%)是主要的单一细菌分离菌株。通过在暴露的血琼脂平板上进行菌落计数发现,病房室内空气中携带4种或更多不同细菌种类的常见医院细菌,且处于危险水平。ICU几乎所有的感染源都显示存在肺炎克雷伯菌、大肠杆菌、假单胞菌和葡萄球菌,因此成为婴儿医院感染的潜在储存源,这可能归因于过度拥挤、通风系统不佳以及未能遵循严格保护性屏障护理的基本原则。