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目的开展环境快速主动监测模式,对多药耐药菌(MDROs)高发病区环境进行监测,做到早发现、早干预。方法运用MDROs鉴定显色培养,对高发产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌及耐甲氧西林金黄色葡萄球菌(MRSA)病区进行目标菌筛检。结果 55份环境物体表面标本,菌落数严重超标,筛检出MDROs,包括产ESBLs大肠埃希菌、产ESBLs肺炎克雷伯菌、MDROs嗜麦芽寡养单胞菌、MDROs阴沟肠杆菌、MRSA、MDROs溶血性葡萄球菌,所有筛选出的耐药菌株使用法国生物梅里埃公司VITEK-32型全自动细菌分析仪再次鉴定与药敏试验,符合率为100.0%;对医院擦拭物体表面的消毒毛巾做调查,合格率仅为28.57%,不合格标本菌落计数均≥1.0×106 CFU/cm2。结论运用MDROs鉴定显色培养基对医院环境进行主动监测,利于快速早期发现环境中定植的MDROs;通过监测发现医院环境和物品污染严重,应加强清洁消毒工作,切断MDROs医院感染传播,对于防止MDROs医院感染暴发流行具有重要意义。
Objective To develop a rapid and active environmental monitoring model to monitor the high incidence of multi-drug resistant bacteria (MDROs) in the environment and achieve early detection and early intervention. Methods By MDROs identification culture, target bacteria were screened for Enterobacteriaceae and methicillin - resistant Staphylococcus aureus (MRSA) in high yield ESBLs - producing strains. Results The number of colonies in 55 environmental objects was seriously exceeded. MDROs were screened out, including Escherichia coli producing ESBLs, ESBLs producing Klebsiella pneumoniae, MDROs Stenotrophomonas maltophilia, MDROs Enterobacter cloacae, MRSA, MDROs hemolytic Staphylococcus aureus, all the selected drug-resistant strains using the French biomedical VITEK-32 automatic bacteriological analyzer re-identification and drug sensitivity test, with a rate of 100.0%; hospital wipe the surface of the disinfectant towels do Survey, the passing rate was only 28.57%, failed samples colony count ≥ 1.0 × 106 CFU / cm2. Conclusion Monitoring the hospital environment by MDROs identification culture medium is conducive to rapid and early detection of MDROs colonized in the environment. By monitoring the hospital environment and the serious pollution of the articles, we should strengthen the cleaning and disinfection work, cut off the transmission of MDROs and prevent the transmission of MDROs The outbreak of nosocomial infection is of great significance.