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題名 | 某區域醫院燒傷中心院內血流感染綠膿桿菌群突發事件之調查=Outbreak of Pseudomonas Aeruginosa Central Venous Catheter Infection in a Burn Unit |
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作者 | 成茵茵; 黃媚聰; 蔡瑞安; 周宗琤; Cheng, Yin-yin; Huang, Mei-tsung; Tsai, Zwei-ann; Chou, Tsung-cheug; |
期刊 | 院內感染控制雜誌 |
出版日期 | 19980200 |
卷期 | 8:1 1998.02[民87.02] |
頁次 | 頁393-399 |
分類號 | 419.38 |
語文 | chi |
關鍵詞 | 綠膿桿菌; 血流感染; 院內感染; Pseudomonas aeruginosa; Blood stream infection; Nosocomial infection; |
中文摘要 | 某區域醫院燒傷中心共計9床;於1997年5月份之燒傷中心病人感染率由5月前6個月平均之8.82%增加至44.4%。在部位感染中以血流感染9例為最高,經院內感染定義收案患者共有4名被感染。經由個案之資料分析及流行病學調查發現感染病人均放置中心靜脈導管,採樣檢體共20件,其中有9件均培養出綠膿桿菌;與由患者中心靜脈導管及血液培養分離出菌株的生化反應及抗生素感受性完全相同。經與前6個月感染率比較具有統計學上的差異(P<0.05),確認是一群突發事件。感控小組立即展開必要之管制措施及調查工作,醫護人員除加強洗手及無菌技術之執行外,尚進行鼻腔及手部之微生物培養,同時亦針對該細菌可能存在之環境進行採檢,並實地觀察病患水療作業之程序,以找出可能的感染來源。結果發現第一位接受水療的患者及負責協助換藥的一名護士之手部和水療裝備之水溫調節器旋轉鈕均帶有與感染個案相同之綠膿桿菌Group E。故加強醫護人員之洗手、遵循各項無菌技術之執行,並對所使用之相關裝備器材消毒處理的認知,將有助於避免類似院內血流感染之再發。 |
英文摘要 | In a burn unit with 9 beds at a regional hospital in southern Taiwan, nosocomial infection rate increased in May, 1997 from an average of 8.82% for the previous 6 months to 44.4%. Four cases fit the definition of nosocomial central venous catheter infection: more than 15 colony counts from the catheter tip, local inflammatory signs with pus, fever, and the same bacteria from the catheter tip and the blood cultures. All were infected by Pseudomonas aeruginosa with drug sensitivity only to amikacin and ciprofloxacin. Using antibiogram and serological typing, they were found to be of the same type belonging to group E. A total of 16 cultures from the environment and 28 specimens from 14 medical and nursing staff (hand and nasal cavity from each) were then taken. Pseudomonas of the same group and drug antimicrobial susceptibility as that from the patients was cultured out of hydrotherapy thermoregulatory valve and the hand of one nurse handling the valve. The valve had not been include in the disinfection proceure following hydrotherapy of each patient, which usually only included hydrotherapy bed and the shower head. Bacterial colonization of the thermoregulatory valve and the nurse's hands is thought to be the cause of this outbreak of Pseudomonas central venous pressure line infection. The outbreak ceased following the discovery and a more thorough and comprehensive disinfection procedured following hydrotherapy of patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。