Patient-to-patient spread of a single strain of Corynebacterium striatum causing infections in a surgical intensive care unit
Patient-to-patient spread of a single strain of Corynebacterium striatum causing infections in a surgical intensive care unit
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DOI：
10.1128/jcm.34.9.2089-2094.1996
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发表时间：
1996-09-01
影响因子：
9.4
通讯作者：
Verbrugh, HA
中科院分区：
文献类型：
--
作者：
Brandenburg, AH;vanBelkum, A;Verbrugh, HA
在 12 个月的时间里，从外科重症监护病房收治的 14 名患者的临床标本中分离出了纹状棒状杆菌菌株。这些分离株的形态和生物型相同，并显示相同的抗菌谱。发现 10 个分离株是唯一可能的病原体，这 10 个分离株来自 6 名患者，其中 3 名患者在培养呈阳性时有感染迹象，通过多态性 DNA 分析的随机扩增进行进一步分型，所有菌株均相同，并发现与参考菌株和其他病房临床样本中发现的分离株有不同程度的差异，在病例对照研究中，获得该菌株的唯一独立危险因素是插管时间超过 24 小时（比值比， 20.09；95% 置信区间，2.29 至 176.09）。从受感染患者附近采样的表面和空气中分离出相同的菌株，但从未从病房其他地方的表面或空气中分离出相同的菌株。该菌株不是从呼吸机中分离出来的，该菌株是从照顾感染患者的人员手中培养出来的，但在医院工作人员中没有发现长期携带者，表明只是暂时携带。我们的结论是，纹状梭菌可在外科重症监护室患者中引起严重的医院感染，并可能通过护理人员的手在患者之间传播。
Over a 12-month period, Corynebacterium striatum strains were isolated from clinical specimens from 14 patients admitted to a surgical intensive care unit. These isolates were identical by morphology and biotype and displayed the same antibiogram. Ten isolates were found to be the sole possible pathogen, These 10 isolates were from six patients, three of whom had signs of infection at the time of positive culture, Further typing was performed by random amplification of polymorphic DNA analysis, by which all strains were identical and were found to differ to various degrees from reference strains and from isolates found in clinical samples from other wards, In a case-control study the only independent risk factor for acquiring the strain was intubation for longer than 24 h (odds ratio, 20.09; 95% confidence interval, 2.29 to 176.09). The same strain was isolated from surfaces and from air sampled in the direct vicinity of infected patients but never from surfaces or air in other places of the ward. The strain was not isolated from the ventilators, The strain was cultured from the hands of personnel attending to infected patients, but no long-term carriers were found among members of the hospital personnel, suggesting transient carriage only. We conclude that C. striatum can cause serious nosocomial infections in surgical intensive care unit patients and may spread from patient to patient via the hands of attending personnel.