上海预防医学2025，Vol.37Issue(4)：301-305,5.DOI:10.19428/j.cnki.sjpm.2025.24819
一起老年急诊病房耐碳青霉烯类肺炎克雷伯菌疑似医院感染暴发的流行病学调查
Epidemiological investigation of a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae in a geriatric emergency ward
陈越 1钱子煜 2张景皓 3刘志勇 2王凯悦 2郁雅艳 1戴旭娟 1贾明磊 1陈越火4
作者信息
- 1. 复旦大学附属华东医院 医院感染管理科,上海 200040
- 2. 上海市徐汇区疾病预防控制中心,上海 200030
- 3. 复旦大学附属华东医院 检验科,上海 200040
- 4. 复旦大学附属华东医院 医院感染管理科,上海 200040||复旦大学医院感染与控制研究所,上海 200032
- 折叠
摘要
Abstract
[Objective]To investigate a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae(CRKP)in a geriatric emergency ward,and to provide references for the prevention and control of multidrug-resistant bacteria in a hospital in Shanghai.[Methods]On-site epidemiological investigation,combined with environmental hygiene monitoring and pulsed field gel electrophoresis(PFGE)molecular typing method,were adopted to investigate a suspected outbreak of CRKP infection in the geriatric emergency ward of a hospital from October to November 2022,aiming at finding out factors caused the outbreak before taking corresponding control measures.[Results]A total of 3 cases of healthcare-associated CRKP infection were identified,of which 2 cases were homologous to a previous case of community-associated CRKP infection.What's more,the 2 cases lived in the same ward with the latter and with adjacent beds,but the third case was non-homologous to the community-associated infection case.A total of 46 samples were collected from the environmental surfaces and the hands of healthcare workers,of which 7 samples tested positive for CRKP and were identical to the strains from the 2 healthcare-associated infection cases and the 1 community-associated infection case,originating from the bedrails,bedside tables,surface of non-invasive ventilator,bed curtains and panels of monitoring equipment,with a detection rate of 15.22%.But none of the 11 samples from the hands of healthcare workers tested positive for CRKP.The outbreak was effectively controlled after taking specific prevention and control measures such as strengthening personnel management,intensifying environmental cleaning and disinfection and strictly enforcing hand hygiene among healthcare workers.Subsequently,no similar new cases were reported during the 14-day follow-up period.[Conclusion]Incomplete environmental cleaning and disinfection,as well as inadequate enforcement of hand hygiene among heatheare workers may have contributed to the suspected outbreak of CRKP in the geriatric emergency ward.Early warning and timely investigation of suspected outbreaks of multidrug-resistant bacteria are crucial for preventing and controlling such outbreaks in hospitals.关键词
耐碳青霉烯类肺炎克雷伯菌/疑似医院感染暴发/老年急诊病房/脉冲场凝胶电泳/流行病学调查Key words
carbapenem-resistant Klebsiella pneumoniae/suspected outbreak of healthcare-associated infection/geriatric emergency ward/pulsed field gel electrophoresis/epidemiological investigation分类
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陈越,钱子煜,张景皓,刘志勇,王凯悦,郁雅艳,戴旭娟,贾明磊,陈越火..一起老年急诊病房耐碳青霉烯类肺炎克雷伯菌疑似医院感染暴发的流行病学调查[J].上海预防医学,2025,37(4):301-305,5.
