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題名 | 新生兒鼻腔與臍帶之葡萄球菌菌叢率= |
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作者 | 周明淵; |
期刊 | 中華民國小兒科醫學會雜誌 |
出版日期 | 19910700、19910800 |
卷期 | 32:4 民80.07-08 |
頁次 | 頁214-218 |
分類號 | 417.517 |
語文 | chi |
關鍵詞 | 菌叢; 新生兒; 葡萄球菌; 鼻腔; 臍帶; |
中文摘要 | 金黃色葡萄球菌和表皮葡萄球菌是本院院內感染重要的致病菌。兩者共佔嬰兒房新生兒所有院內感染致病菌之56.2%,尤其是前者所造成之皮膚感染更具嚴重性,給醫護人員和感染管制人員帶來莫大的困擾。為探討其原因及研究如何有效降低新生兒身上之菌叢率,本組分三階段採得新生兒鼻腔和臍帶檢體共計1578件;第一階段則予新生兒洗澡後,不加任何消毒劑於臍帶上,第二和第三階段則分別以beta-iodine in alcohol及bacitracin ointment處理臍帶。結果發現新生兒住進嬰兒房一天後,因消毒方式不同,其臍帶之金黃色葡萄球菌和表皮葡萄球菌菌叢率,利用卡方檢定後即有統計學上顯著差異(p<0.05),鼻腔之菌叢率則到第二天後才有顯著差異。在使用bacitracin ointment處理新生兒臍帶的階段,嬰兒房沒有發現任何皮膚感染之個案。各階段所分離之金黃色葡萄球茵,大部份對ampicillin、erythromycin、penicillin和tetracycline具抗藥性,此種抗藥型(antibiogram)分離自鼻腔和臍帶分別佔44%及56%,且與去年和前年造成嬰兒房新生兒皮膚感染之金黃色葡萄球菌抗藥型相同。因此,除加強管制嬰兒房之工作人員、環境、使用物品和器械,以及隔離技術外,確實有必要選擇有效之消毒劑(bacitracin ointment)以降低菌叢率,減少嬰兒房之感染率。 |
英文摘要 | Staphylococcus aureus and Staphylococcus epidermidis were the most important gram positive pathogens found in a five-year study (1985-1989) of nosocomial infection in this hospital. They caused 56.2% of all nosocomial infections in this newborn nursery, particularly skin infections. To determine the reasons, and to decrease effectively the neonatal staphylococcal colonization rate, three different disinfection methods were selected for management of neonatal umbilical cords. A total of 1578 swabs from neonatal nares and umbilical cords were collected. During the first period no disinfectant was applied to the cord after bathing the baby. Beta-iodine in alcohol and bacitracin ointment were used for the second and the third periods, respectively. The result showed a significant difference (P<0.05) in staphylococcal colonization rate on neonatal umbilical cord using different disinfectants even after the first day. The same result for neonatal nares was also found, after infants had been in the nursery for two days. During the third period, no case of skin infection was found. Most Staphylococcus aureus isolated were resistant to ampicillin, erythromycin, tetracycline and penicillin. The percentage of this antibiogram found in neonatal nares and umbilical cords was 44% and 56% respectively. Besides nosocomial infection control and surveillance of medical personnel, enviroment, materials, instruments and isolation techniques, it is really necessary to choose an effective disinfectant (bacitracin ointment is recommended) to reduce the staphylococcal colonization in newborn nurseries. |
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