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題 名 | 神經加護中心黏質沙雷氏桿菌院內泌尿道感染群突發調查=An Outbreak of Serratia Marcescens Nosocomial Urinary Tract Infections in a Neurological Intensive Care Unit |
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作 者 | 嚴小燕; 陳依雯; 張靜美; 林金絲; 王志堅; 陳繼祥; 李正華; | 書刊名 | 院內感染控制雜誌 |
卷 期 | 7:6 1997.12[民86.12] |
頁 次 | 頁333-339 |
分類號 | 419.38 |
關鍵詞 | 黏質沙雷氏桿菌; 泌尿道感染; 院內感染; Serratia marcescens; Urinary tract infections; Nosocomial infection; |
語 文 | 中文(Chinese) |
中文摘要 | 某教學醫院神經加護中心於1995年9月至1996年5月共計13位病患發生黏質沙雷氏桿菌 (Serratia marcescens) 引起之院內泌尿道感染, 與前一年感染率比較具統計上意義,為一院內感染群突發。因此進行調查,希望找出致病因素及感染源。經採檢環境及工作人員雙手,結果發現六個尿量杯 (75 %)及二個尿比重計 (50 %)被黏質沙雷氏桿菌污染,其抗生素感受型與由病患分離出的黏質沙雷氏桿菌的抗生素感受型相似,因此我們認為尿量杯及尿比重計可能是主要的感染源,藉由工作人員的雙手在病人之間的交互感染及傳播。經加強院內感染管制措施,要求工作人員加強洗手,照顧病患時要更換手套,及改正與尿液有關醫療設備的消毒方法後,有效的阻斷感染源,追�j至今並沒有新的感染個案發生,結束了這次的群突發事件。 |
英文摘要 | From September, 1995 through May, 1996, thirteen cases of nosocomial urinary tract infections due to Serratia marcescens occurred in a neurological intensive care unit at a medical center in Taipei. All the isolates had the same antibiotic sensitivity pattern. There was only one such infection during the previous 12 months. The difference in the incidence was statistically significant. Thus, an investigation was started to look for the source of the outbreak. All cases had indwelling urinary catheter, and had been in the intensive care unit for an average of 16 days. The average duration between the time the catheter was placed and the onset of infection was 16 days. Environmental cultures were performed which included four urinometers, eight urine containers, and eleven specimens taken from sinks and the faucets in the unit, and hands of the medical and the nursing staff. Cultures of two of the four urinometers and six of the eight urine containers revealed the growth of the Serratia, all of which had nearly identical antibiograms as that from the patients' isolates. These contaminated items were probably the source of the outbreak through hands of the staff caring for the patients. Staff education was enforced regarding the proper use of gloves and handwashing. The urine containers were soaked for 15 minutes with 0.6 % sodium hypochlorite, and the urinometers were wiped with 75 % alcohol and kept dry after each use. A separate urinometer was employed for each patient. The unit was cleaned thoroughly, and the sink was washed and the floor mopped with 1:100 dilution of the household bleach daily. No Serratia urinary tract infection was noted in the unit since the staff re-education and other preventive measures were taken. |
本系統中英文摘要資訊取自各篇刊載內容。