Contaminated enteral nutrition solutions as a cause of nosocomial bloodstream infection: a study using plasmid fingerprinting.
Contaminated enteral nutrition solutions as a cause of nosocomial bloodstream infection: a study using plasmid fingerprinting.
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受污染的肠内营养液是院内血流感染的一个原因：一项使用质粒指纹分析的研究。
DOI：
10.1177/0148607189013003228
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
R. P. Wenzel
中科院分区：
文献类型：
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作者：
Jack Levy;Y. Laethem;Godelieve Verhaegen;Chantal Perpête;J. Butzler;R. P. Wenzel
1984年7月，两名患者喂食了被阴沟肠杆菌污染的肠内营养液，发生了院内菌血症。尽管对制备程序进行了仔细审查，并反复进行了微生物调查，但在一年内测试的309个配方奶粉中，有83个（27%）被污染，污染源仍然未知。E.梭菌是最常见的微生物分离（34%）。质粒图谱显示E.从肠内营养溶液中回收的氯吡格雷在几个月内保持不变。40例患者中有10例血培养分离出E.在7年期间（1979-1985）的Cloenosophy医院败血症中，质粒谱将它们与污染的肠内营养溶液联系起来。一项病例对照研究的流行病学数据显示，这10名患者确实比其他30名患者更有可能接受肠内营养：9/10 vs 10/30（比值比18，p = 0.002）。同样，1986年6个月内7例医院内肺炎克雷伯氏菌感染中有2例可归因于受污染的肠内液体喂养，这促使了使用无菌商业制备溶液的一般政策。我们的研究结果表明，污染的肠内营养液是医院感染的一个重要原因。
In July 1984, two patients fed enteral nutrition solutions contaminated with Enterobacter cloacae developed nosocomial bacteremia. Despite careful review of the preparation procedures as well as repeated microbiological surveys, 83 (27%) of the 309 formula bottles tested over a 1-yr period were contaminated and the source of contamination remained unknown. E. cloacae was the most frequent organism isolated (34%). The plasmid profiles of E. cloacae recovered from enteral nutrition solutions remained identical for several months. Blood culture isolates from 10 of the 40 patients who had developed E. cloacae nosocomial sepsis over a 7-yr period (1979-1985) had plasmid profiles linking them to contaminated enteral nutrition solutions. Epidemiological data from a case control study revealed that these 10 patients were indeed more likely to be exposed to enteral nutrition than the 30 others: 9/10 vs 10/30 (odds ratio 18, p = 0.002). Similarly, two of seven nosocomial Klebsiella pneumoniae bacteremias over a 6-month period in 1986 could be ascribed to administration of contaminated enteral liquid feeds prompting a general policy for using sterile commercially prepared solutions. Our results suggest that contaminated enteral nutrition solutions represent a significant cause of nosocomial sepsis.