特大地震伤员多重耐药鲍曼不动杆菌医院感染与防控策略
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摘要
目的总结特大地震伤员多重耐药鲍曼不动杆菌群聚医院的感染防控策略,开辟多重耐药鲍曼不动杆菌以及其他多重耐药株医院感染防控新思维及有效方法。方法在华西医院预分诊处对地震伤员的伤口分泌物进行细菌学检查和分析,据此提出群聚医院感染防控策略并实施。结果地震伤员中伤口分泌物30例为多重耐药鲍曼不动杆菌经过采取群聚医院感染防控策略等综合措施,共有22例伤口分泌物培养阴性,病情痊愈出院;8例伤口分泌物系多重耐药鲍曼不动杆菌,病情相对稳定,未再有其他新的地震伤员伤口分泌物培养出多重耐药鲍曼不动杆菌。结论对多重耐药鲍曼不动杆菌地震伤员采取群聚医院感染防控策略,能有效控制多重耐药鲍曼不动杆菌及其他全耐药株医院感染。
Objective To summarize the experience of preventing and controlling the infection with muti drug resistant(MDR) acinetobacter baumanii and create a new way to prevent and control such infections effectively.Methods From May 14th to June 24th,2008,secretions for patients injured in the Wenchuan Earthquake were cultured to detect the pathogenic bacteria,followed by bringing forward a preventing strategy against such multitudinous infections.Results Up to June 24th,Baumanii,which were multidrug resistant,were detected in thirty cases.After the preventing and controlling measures were implemented,twenty-two cases recovered and discharged from the hospital,and their secretions were cultured without any bacteria.But there were still eight cases whose secretions were cultured with positive results for multidrug resistant Baumanii.Fortunely,their conditions were stable,and nobody was infected by Baumanii any more.Conclusion Preventing and controlling strategy played an effective role in preventing and controlling hospital infections,including A.baumanii.
Objective To summarize the experience of preventing and controlling the infection with muti drug resistant(MDR) acinetobacter baumanii and create a new way to prevent and control such infections effectively.Methods From May 14th to June 24th,2008,secretions for patients injured in the Wenchuan Earthquake were cultured to detect the pathogenic bacteria,followed by bringing forward a preventing strategy against such multitudinous infections.Results Up to June 24th,Baumanii,which were multidrug resistant,were detected in thirty cases.After the preventing and controlling measures were implemented,twenty-two cases recovered and discharged from the hospital,and their secretions were cultured without any bacteria.But there were still eight cases whose secretions were cultured with positive results for multidrug resistant Baumanii.Fortunely,their conditions were stable,and nobody was infected by Baumanii any more.Conclusion Preventing and controlling strategy played an effective role in preventing and controlling hospital infections,including A.baumanii.
引文
[1]陈萍,刘丁,陈伟.鲍曼不动杆菌医院感染调查及其危险因素探讨[J].中国现代医学杂志,2003,13(4):59.
[2]Zarrulli R,Crispino M,Bagattini M,et a1.Molecular epidemiologyof sequential outbreaks of Acinetobacter bau-mannii in an inten-sive care unit shows the emergence of carbapenem resistance[J].JClin Microbiol,2004,42(3):946-953.
[3]王辉,孙宏莉,宁永忠,等.不动杆菌属多重耐药及泛耐药的分子机制研究[J].中华医学杂志,2006,86(1):17-22.
[4]Manikal VM,Landman D,Saurina G,et a1.Endemic carbapenem-resistant Aeinetobacter species in Brooklyn,New York:citywideprevalence,interinstitutional spread,and relation to antibiotic us-age[J].Clin Infet Dis,2000,31(1):101-106.
[5]程曦,漆涌,陶莹,等.鲍曼不动杆菌的耐药表型及耐药基因的表达.中国热带医学杂志,2006,6(6):1061-1062.
[6]石应康.汶川地震医疗救援中区域性国家级医院的战略支撑作用[J].中国循证医学杂志,2008,8(6):380-382.
[2]Zarrulli R,Crispino M,Bagattini M,et a1.Molecular epidemiologyof sequential outbreaks of Acinetobacter bau-mannii in an inten-sive care unit shows the emergence of carbapenem resistance[J].JClin Microbiol,2004,42(3):946-953.
[3]王辉,孙宏莉,宁永忠,等.不动杆菌属多重耐药及泛耐药的分子机制研究[J].中华医学杂志,2006,86(1):17-22.
[4]Manikal VM,Landman D,Saurina G,et a1.Endemic carbapenem-resistant Aeinetobacter species in Brooklyn,New York:citywideprevalence,interinstitutional spread,and relation to antibiotic us-age[J].Clin Infet Dis,2000,31(1):101-106.
[5]程曦,漆涌,陶莹,等.鲍曼不动杆菌的耐药表型及耐药基因的表达.中国热带医学杂志,2006,6(6):1061-1062.
[6]石应康.汶川地震医疗救援中区域性国家级医院的战略支撑作用[J].中国循证医学杂志,2008,8(6):380-382.
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