Control of a prolonged outbreak of extended-spectrum β-lactamase-producing Enterobacteriaceae in a university hospital
Control of a prolonged outbreak of extended-spectrum β-lactamase-producing Enterobacteriaceae in a university hospital
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DOI：
10.1086/313511
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发表时间：
1999-12-01
影响因子：
11.8
通讯作者：
Régnier, B
中科院分区：
文献类型：
--
作者：
Lucet, JC;Decré, D;Régnier, B
我院1989-1991年从130 ~ 140例/年的临床标本中分离出产超广谱β-内酰胺酶肠杆菌科（ESBLPE）。1992年2月，启动了一项控制计划：在3个重症监护室（ICU）进行筛查试验，并在所有单位采取接触隔离预防措施。脓毒症外科病房作为隔离病房，用于隔离ESBLPE的外科患者。1992年ESBLPE的发生率没有下降，大多数发生在3个ICU。对这些ICU实施隔离程序的关键评价提示了屏障预防措施的纠正措施。后天感染病例的发生率随后有所下降，第二次评价确定这些措施得到了正确应用。感染性外科病房的获得性病例发生率低于其他病房。还发现其他手传播的多重耐药微生物的获得率下降。隔离预防措施、ICU患者筛查试验和ICU出院后队列分组可有效控制多重耐药微生物通过交叉污染传播，在不限制抗菌药物使用的情况下有效控制了疫情。
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLPE) were isolated from clinical specimens from 130 to 140 patients/year in 1989-1991 in our hospital. In February 1992, a control program was initiated: screening tests in 3 intensive care units (ICUs) and contact-isolation precautions in all units. The septic surgical unit served as an isolation ward for surgical patients from whom ESBLPE was isolated. In 1992, the incidence of ESBLPE acquisition failed to decrease, and most acquisitions occurred in 3 ICUs. Critical evaluation of implementation of isolation procedures in these ICUs prompted corrective measures for barrier precautions. The incidence of acquired cases subsequently decreased, and a second evaluation determined that these measures had been correctly applied. The incidence of acquired cases in the septic surgical unit was lower than those in the other units. Decreases were also found in the incidence of acquisition of other hand-transmitted multidrug-resistant organisms. Barrier precautions, screening tests for ICU patients, and grouping of cohorts after ICU discharge are effective in controlling the spread of multidrug-resistant microorganisms by cross-contamination, The outbreak was effectively controlled without restricting antimicrobial use.