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目的研究重症监护室泛耐药鲍曼不动杆菌(PDR-AB)感染危险因素及控制措施。方法采用现场采样检验和药敏试验方法,对某医院呼吸重症监护室(RICU)一起下呼吸道泛耐药鲍曼不动杆菌杆菌暴发流行事件进行调查。结果该医院重症监护室2010年8月24日～12月13日期间连续发生了6例下呼吸道医院感染病例。经药敏试验证明,所检出的鲍曼不动杆菌对临床常用22种抗菌药物中的20余种耐药,且耐药谱相同或相近。经对室内空气及环境表面采样检验,在床具栏杆、呼吸机面板、护士办公室电话机表面等均检出(PDR-AB)。结论此次泛耐药鲍曼不动杆菌感染来源于RICU环境污染,呈广泛耐药性,经医护人员手传播,经过积极治疗病人,采用消毒隔离,强化环境清洁与消毒措施,有效控制了感染流行。
Objective To study the risk factors and control measures of pan-drug resistant Acinetobacter baumannii (PDR-AB) in intensive care unit. Methods An outbreak of pan-drug-resistant Acinetobacter baumannii was performed in a hospital respiratory intensive care unit (RICU) with on-site sampling and drug susceptibility testing. Results The hospital intensive care unit from August 24, 2010 to December 13, a series of consecutive cases of lower respiratory tract nosocomial infections. The drug susceptibility test showed that Acinetobacter baumannii detected more than 20 commonly used drugs in clinical 22 kinds of antimicrobial resistance, and resistance spectrum the same or similar. After indoor air and environmental surface sampling test, the bed railings, ventilator panels, nurses office phone surface were detected (PDR-AB). Conclusion The pan-drug-resistant Acinetobacter baumannii infection originated from RICU\'s environmental pollution and was widely drug-resistant. It was transmitted by medical staff. After active treatment of patients, disinfection and isolation, enhanced environmental cleaning and disinfection measures were adopted to effectively control the infection popular.