摘要
Abstract
Objective To investigate Candida albicans(C.auris)colonization in patients and environmental con-tamination of non-intensive care unit(non-ICU)in a hospital,and evaluate the effectiveness of infection prevention and control measures in non-ICU.Methods In March 2024,a paraplegic patient admitted to the department of re-habilitation medicine was found to have C.auris in both urinary catheter and urine culture.The patient was immedia-tely isolated in single room,and patient transfer-in/out of non-ICU was suspended.Fungal cultures were performed on specimens from the ward environment,caregivers,doctors,nurses,and co-hospitalized patients.Mass spec-trometry and molecular biology techniques were used for strain identification and cluster analysis.Contact isolation was conducted on patient.Prevention and control measures were taken,including strict hand hygiene,1 000 mg/L chlorine-based(sodium hypochlorite)disinfection,2％chlorhexidine decolonization,and terminal disinfection of pa-tient-contact items.After discharge,these measures continued with regular C.auris surveillance.Results Five strains of C.auris were isolated from the patient's urine,urinary catheter,inguinal swab,perianal swab,and bed rail swab.Protein mass spectrometry cluster analysis confirmed clonal relatedness of all isolates.The strain showed resistance to fluconazole and amphotericin B,but susceptibility to echinocandins.No C.auris was detected from healthcare workers'hand/axillary/groin swabs.After intervention(such as decolonization and environmental disin-fection),follow-up cultures were negative for C.auris.Conclusion Based on the characteristics of admitted pa-tients,non-ICU should implement active prevention and control measures including:admission screening,contact precautions,object surface microbiological monitoring,decolonization,environmental disinfection,and community management.Hand hygiene,contact isolation,and terminal disinfection are crucial for preventing C.auris trans-mission.关键词
耳念珠菌/定植/泌尿道/医院感染/主动筛查/去定植Key words
Candida auris/colonization/urinary tract/healthcare-associated infection/active screening/decoloni-zation分类
医药卫生
