Outbreak of extended-spectrum β-lactamase-producing Klebsiella oxytoca infections associated with contaminated handwashing sinks(1).
Outbreak of extended-spectrum β-lactamase-producing Klebsiella oxytoca infections associated with contaminated handwashing sinks(1).
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与受污染的洗手水槽相关的产生延长的谱系β-内酰胺酶的β-内酰胺酶的爆发（1）。
DOI：
10.3201/eid1808.111268
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发表时间：
2012-08
影响因子：
11.8
通讯作者：
Mount Sinai Hospital Infection Control Team
中科院分区：
文献类型：
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作者：
Lowe C;Willey B;O'Shaughnessy A;Lee W;Lum M;Pike K;Larocque C;Dedier H;Dales L;Moore C;McGeer A;Mount Sinai Hospital Infection Control Team
汇是环境与患者以及患者与患者之间传播的潜在储存库。产酸克雷伯菌主要是一种从环境来源获得的与医疗保健相关的病原体。 2006 年 10 月至 2011 年 3 月期间，加拿大安大略省多伦多市一家医院共有 66 名患者感染了 A 类产超广谱 β-内酰胺酶产产 K. oxytoca，并具有 2 种相关脉冲场凝胶电泳图谱中的 1 种。尽管加强了感染控制措施、流行病筛查以及对定植/感染患者的接触预防措施，但新病例仍在继续发生。来自重症监护病房洗手池的培养物产生了催产克雷伯氏菌，其脉冲场凝胶电泳模式与临床病例的培养物相同。实施每天 3 次水槽清洁、水槽排水改造和抗菌管理计划后，未发生感染。相比之下，在一个地理位置较远、没有受污染水槽的医疗病房内，有 4 名感染克氏杆菌的患者被控制住，并采取了积极的筛查和接触预防措施。水槽应被视为催产克雷伯氏菌引起的集群感染的潜在储存库。
Sinks are a potential reservoir for environment-to-patient and patient-to-patient transmission. Klebsiella oxytoca is primarily a health care–associated pathogen acquired from environmental sources. During October 2006–March 2011, a total of 66 patients in a hospital in Toronto, Ontario, Canada, acquired class A extended-spectrum β-lactamase–producing K. oxytoca with 1 of 2 related pulsed-field gel electrophoresis patterns. New cases continued to occur despite reinforcement of infection control practices, prevalence screening, and contact precautions for colonized/infected patients. Cultures from handwashing sinks in the intensive care unit yielded K. oxytoca with identical pulsed-field gel electrophoresis patterns to cultures from the clinical cases. No infections occurred after implementation of sink cleaning 3×/day, sink drain modifications, and an antimicrobial stewardship program. In contrast, a cluster of 4 patients infected with K. oxytoca in a geographically distant medical ward without contaminated sinks was contained with implementation of active screening and contact precautions. Sinks should be considered potential reservoirs for clusters of infection caused by K. oxytoca.