CAJ | 학술논문

目的：对发生于重症监护病房（ICU）的鲍曼不动杆菌（ABA）医院感染暴发进行调查，为控制医院感染提供依据和对策。方法按《医院消毒技术规范》要求进行采样和细菌培养，对患者、环境来源菌株进行细菌鉴定和药敏试验。结果环境中ABA检出率从高到低依次为吸痰小瓶（88．9％）、护工手（60．0％）、呼吸机回路（37．5％）、医务人员手（28．0％）、床头桌面（25．0％）、鼻拭子（13．3％）、设备按钮（12．5％）、医务人员工作服（12．0％）、工作人员拖鞋底（6．7％）。患者痰标本和医院环境中分离到的ABA具有相同的耐药菌谱。此次感染暴发的感染源为1例ABA感染患者，暴发原因为呼吸机回路非一次性使用和医护人员手卫生依从性差。结论规范医务人员操作行为、严格无菌技术、加强病房环境管理、提高医护人员手卫生依从性，能有效预防和控制医院感染。
목적：대발생우중증감호병방（ICU）적포만불동간균（ABA）의원감염폭발진행조사，위공제의원감염제공의거화대책。방법안《의원소독기술규범》요구진행채양화세균배양，대환자、배경래원균주진행세균감정화약민시험。결과배경중ABA검출솔종고도저의차위흡담소병（88．9％）、호공수（60．0％）、호흡궤회로（37．5％）、의무인원수（28．0％）、상두탁면（25．0％）、비식자（13．3％）、설비안뉴（12．5％）、의무인원공작복（12．0％）、공작인원타혜저（6．7％）。환자담표본화의원배경중분리도적ABA구유상동적내약균보。차차감염폭발적감염원위1례ABA감염환자，폭발원인위호흡궤회로비일차성사용화의호인원수위생의종성차。결론규범의무인원조작행위、엄격무균기술、가강병방배경관리、제고의호인원수위생의종성，능유효예방화공제의원감염。
Objective To review the recent nosocomial outbreak of Acinetobacter baumannii (ABA) in inten-sive care unit (ICU ) ,in order to provide the protective strategy for the management of hospital infection .Methods According to the standard procedure ,samples of hospital environments of ICU and patients were collected for identi-fication of bacteria and drug sensitive test .Results The incidences of ABA were 88 .9% of suction bottle ,60 .0% of the hands of nurses ,37 .5% of ventilator circuits ,28 .0% of physician′s hands ,25% of the face of bed table ,13 .3%of nose swab ,12 .5% of the buttons of monitor ,12 .0% of the clothes of physicians and 6 .7% of the slippers .ABA strains isolated from sputum samples of patients and from hospital environment were with the same drug sensitivity . Conclusion Outbreak of nosocomial infection could be cause by non-disposable use of suction buttle ,poor compliance of hand washing and limited education .Therefore ,strategies to improve these protocols might provide the protective strategy for the management of hospital infection .