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頁籤選單縮合
題 名 | 某區域醫院燒傷中心Oxacillin Resistant Staphylococcus Aureus群突發調查=Investigation of Oxacillin-Resistant Staphylococcus Aureus Outbreak in the Burn Center of a Regional Hospital in Taiwan |
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作 者 | 林育柔; 林香蘭; | 書刊名 | 院內感染控制雜誌 |
卷 期 | 9:4 1999.08[民88.08] |
頁 次 | 頁201-207 |
分類號 | 419.38 |
關鍵詞 | 院內感染; 群突發; 抗Oxacillin金黃色葡萄球菌; ORSA; Nosocomial infection; Outbreak; Oxacillin-resistant staphylococcus aureus; |
語 文 | 中文(Chinese) |
中文摘要 | 某區域醫院燒傷中心根據每月感染報告發現於1998年3月oxacillin resistant Staphylococcusaureus(ORSA)的感染率(36.36%)與前6個月平均感染率(2.73%)比較,有明顯增加的趨勢,病患分別發生傷口、呼吸道及血流感染,尤其以傷口感染為最常見。受感染共有8例,經院內感染定義收案患者有4例。經與前六個月之感染率比較,具有統計學上顯著差異(P<0.05),確認是一群突發事件。經流行病學調查發現個案均屬重度燒傷,且放置各種侵入性醫療裝置,使用多種抗生素,而接受過水療換藥。經感控小組決定後,立即展開必要的管制措施及調查工作,進行環境消毒及醫護工作人員鼻腔、手部之微生物培養,同時針對該細菌可能存在之環境進行採檢,以找出可能感染來源。結果一名醫師鼻部有ORSA,故給予mupirocin藥膏治療並繼續追蹤。因無法排除病患帶菌的可能,故訂定入院新病患鼻腔採檢之常規,提早給予分區隔離措施,有效管制抗生素的使用,加強醫護人員洗手,遵循各項無菌技術之執行,而加強周遭環境及所使用之相關裝備器材消毒處理,有效的控制此次ORSA院內感染群突發。 |
英文摘要 | In the burn center of a regional hospital in Taiwan, an apparent increase in the incidence of oxacillin-resistant Staphylococcus aureus infection was noted in March, 1998. The infection occurred in the respiratory tract, blood stream and wounds, most frequently in the wounds. There were 8 cases of infection, and 4 of them fit the criteria of hospital-acquired. The infection rate was 36.36% (4/11), compared with the average rate of 2.73% (2/73) of the previous 6 months at the same unit (p<0.05). The incidence was confirmed as an outbreak. Investigations revealed that all cases had severe burn, various invasive devices, used multiple antibiotics and received hydrotherapy. Environmental disinfection was carried out. Specimens were taken from potential sites of colonization in the ward and health care workers' hands and nostrils for bacterial culture. A doctor's nostril was found to harbor the bacteria and mupirocin ointment was applied locally and the culture repeated. New patients were routinely screened for the bacterial carriage in the nose, and the patients isolated if necessary. The outbreak stopped following the re-enforcement of the control of the antibiotic usage, hand washing, strict adherence to aseptic techniques, sterilization of equipment and disinfection of the environment. |
本系統中英文摘要資訊取自各篇刊載內容。