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目的了解亚热带地区医院环境表面和人员体表携带菌情况,以指导临床合理使用消毒剂,科学有效地开展医院感染控制工作。方法 2013年10月对解放军总医院海南分院的环境表面、医护人员和患者进行现场采样,同时采用直接接种法和稀释法进行培养,用全自动细菌鉴定质谱仪进行菌种鉴定。结果在300份标本中共培养阳性115份,阳性率为38.3%;检出革兰阴性菌占53.0%,革兰阳性菌占23.5%,真菌占18.3%,排名前6位为不动杆菌属、凝固酶阴性葡萄球菌、假丝酵母菌属、丝状真菌、肺炎克雷伯菌、肠球菌属,分别占21.7%、12.2%、9.6%、7.8%、7.0%、7.0%;真菌在医院各类仪器设施表面、医护人员和患者体表均有检出。结论以海南为代表的亚热带地区,气候湿润温暖,医院环境表面和人员中的携带菌分布和其他地区有明显差异,尤其是真菌分布广泛,提示应加强这类环境的消毒清洁工作和重点菌群的预防控制措施。
Objective To understand the surface environment of the hospital environment in the subtropical area and the carrying capacity of surface bacteria, in order to guide the rational use of disinfectants in clinical practice and carry out scientific and effective hospital infection control. Methods In October 2013, the environmental surface, medical staffs and patients of Hainan Branch of Chinese PLA General Hospital were sampled on site. At the same time, direct inoculation method and dilution method were used for the culture. The strains were identified by automatic bacterial identification mass spectrometry. Results A total of 115 positive samples were cultured in 300 samples, with a positive rate of 38.3%. Gram-negative bacteria were found in 53.0%, gram-positive bacteria in 23.5% and fungi in 18.3%. The top 6 were Acinetobacter, Staphylococcus aureus, Candida, filamentous fungi, Klebsiella pneumoniae and Enterococcus were 21.7%, 12.2%, 9.6%, 7.8%, 7.0% and 7.0% Class equipment surface, medical staff and patients were detected body surface. Conclusion The subtropical region represented by Hainan has a warm and humid climate. The distribution of carrying bacteria in the surface and personnel of the hospital environment is obviously different from other regions. In particular, the distribution of fungi is widespread, suggesting that the disinfection and cleaning work and the key flora of such environment should be strengthened Prevention and control measures.