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題 名 | Outbreaks of Nosocomial Bloodstream Infections Associated with Multiresistant Klebsiella pneumoniae in a Pediatric Intensive Care Unit=多重抗藥性Klebsiella pneumoniae在小兒科加護病房內造成的院內血流感染群突發之調查經驗 |
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作 者 | 蘇玲慧; 吳竹蘭; 邱月璧; 賈儒馨; 郭安靜; 孫建峰; 林奏延; 呂學重; | 書刊名 | 長庚醫學 |
卷 期 | 24:2 2001.02[民90.02] |
頁 次 | 頁103-113 |
分類號 | 419.38 |
關鍵詞 | 肺炎克雷伯氏菌; 小兒科; 院內血流感染; 群突發; Klebsiella pneumoniae; Pediatrics; Nosocomial bloodstream infection; Outbreak; |
語 文 | 英文(English) |
英文摘要 | Background: Between June and October 1997, and during April 1998, a cluster of nosocomial bloodstream infections (BSIs) associated with Klebsiella pneumoniae was observed in 8 premature neonates from 1 pediatric intensive care unit (TPICU) in a 4000-bed medical center in northern Taiwan. An investigation was conducted to identify the possible reservoirs and mode of transmission. Methods: Epidemiologic surveillance and infection control interventions were executed. The environment was checked by submitting several swab samples for microbiological studies. The antibiograms and results from 2 molecular typing methods (pulsed-field gel electrophoresis and infrequent-restriction site polymerase chain reaction) of all bacteremic and environmental isolates of K. pneumoniae were compared. Results: Totally 39 K. pneumoniae isolates, including 9 from bacteremia, 26 from the environment, and 4 controls, were analyzed. One major pattern was found in 21 isolates, which included 8 bacteremic isolates with identical antibiograms, a single isolate from rectal swab screening, 2 of 8 isolates from hand cultures of medical staff, and 10 of 17 isolates from swabs of sinks in the TPICU. All 21 isolates illustrated identical antibiograms, while the other 18 isolates shared 4 antibiograms and 15 unique patterns. Conclusions: The nosocomial BSIs appeared to be an outbreak induced by 1 multiresistant K. pneumoniae strain. The sinks may have acted as reservoirs for this outbreak strain. During washing, splattered water droplets containing the bacterial particles may have contaminated the hands of medical personnel and were then further transmitted to patients.(Chang Gung Med J 2001;24:103-13) |
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