Outbreak of Acinetobacter baumannii in an intensive care unit associated with tracheostomy
Outbreak of Acinetobacter baumannii in an intensive care unit associated with tracheostomy
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DOI：
10.1067/mic.2001.114232
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发表时间：
2001-10-01
影响因子：
4.9
通讯作者：
Bannatyne, RM
中科院分区：
文献类型：
--
作者：
Mah, MW;Memish, ZA;Bannatyne, RM
进行了一项病例对照研究，以确定在重症监护病房获得鲍曼不动杆菌流行株的危险因素。流行株经脉冲场凝胶电泳鉴定，15例患者中有13例（87%）从气管分泌物中分离出。在逻辑回归分析中，气管切开术的存在是不动杆菌属感染的独立风险（比值比，421; 95%置信区间，13.9-12925; P = 0.001），相关性强度与机械通气持续时间呈负相关。该次爆发恰逢在重症监护室引入早期经皮气管切开术的政策，可能是由于呼吸道护理期间感染控制措施不足所致。没有发现环境水库。制定接触预防措施，加强洗手和工作人员教育与疫情的解决有关。
A case-control study was conducted to determine risk factors for acquisition of an epidemic strain of Acinetobacter baumannii in an intensive care unit. The epidemic strain was identified by pulsed-field gel electrophoresis and was isolated from tracheal secretions in 13 (87%) of 15 patients. In a logistic regression analysis, presence of a tracheostomy was, an independent risk for Acinetobacter sp acquisition (odds ratio, 421; 95% confidence intend, 13.9-12925; P = .001) and the strength of the association was inversely related to the duration of mechanical ventilation. The outbreak coincided with the introduction of a policy of early percutaneous tracheostomy in the intensive care unit and probably resulted from inadequate infection control practices during respiratory care. No environmental reservoir was found. Institution of contact precautions, enhanced handwashing and staff education was associated with resolution of the outbreak.