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目的分析肺炎克雷伯菌(KP)在神经危重症监护病房(NICU)环境中的传播情况和定植状态,从而为临床KP感染的预防控制提供理论依据。方法对医院NICU2015年1月-10月空气环境和KP感染患者的周围空气和病床单位进行细菌学目标监测,并应用脉冲场凝胶电泳法对于分离出的KP菌株进行同源性分析。结果在收治221例患者中有154例感染患者,感染率为69.68%,其中148例进行病原学检查,检出非重复病原菌99株,其中KP 25株,占25.25%,在NICU感染患者的病房环境细菌学监测中共检出KP 3株,有2株分别来源于1例病毒性脑炎患者的空气和床头柜表面采集标本,1株来源于KP感染患者周围空气标本,对其中27株KP分离株成功分型。在27株菌PFGE谱型中,1521Y和1521、1501和1513、1520和1525为同一型;A’和T’为同一型,且与1503菌株相似度为86.7%。结论 NICU病房环境不但是KP感染的重要传播途径,而且KP能够在NICU的病房空气和床头柜等病床单位环境中定植生存,从而成为重要的感染源。
Objective To analyze the propagation and colonization status of Klebsiella pneumoniae (KP) in the neurological critical care unit (NICU) environment and provide a theoretical basis for the prevention and control of clinical KP infection. Methods The bacteriological targets of air environment and hospital bed units of NICU patients in air environment and KP infection from January to October 2015 in NICU were monitored. Pulsed-field gel electrophoresis was used to analyze the homology of isolated KP strains. Results Among the 221 patients, 154 cases were infected and the infection rate was 69.68%. 148 of them were etiologically examined. 99 non-repetitive pathogens were detected, of which 25 were KP, accounting for 25.25%. In the NICU-infected ward Three KP strains were detected in environmental bacteriological monitoring. Two samples from air and nightstands were collected from one patient with viral encephalitis. One sample was from ambient air samples from patients with KP infection. Among them, 27 KP isolates Successful typing. Among the 27 strains of PFGE, 1521Y and 1521, 1501 and 1513, 1520 and 1525 were of the same type; A ’and T’ were of the same type, and the similarity with strain 1503 was 86.7%. Conclusion The NICU ward environment is not only an important route of transmission of KP infection, but also KP can be an important source of infection in NICU’s ward air environment and bedside cabinet units.