一起耐碳青霉烯类肺炎克雷伯菌聚集事件的调查与分析
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R181.3+2

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Investigation and analysis of a cluster event of carbapenem-resistant Klebsiella pneumoniae
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    摘要:

    目的 对某中医院重症监护病房(ICU)发生的一起耐碳青霉烯类肺炎克雷伯菌(CRKP)聚集事件进行调查,为医院内多重耐药菌的防控提供参考。方法 2023年1—7月,某中医院ICU出现多例CRKP感染患者,检出水平超过历年同期水平。收集患者临床信息,并进行流行病学调查、环境卫生学监测,对所分离的CRKP进行脉冲场凝胶电泳(PFGE)鉴定,查找可能传播的原因,并采取相应的控制措施。结果 研究期间共确认13例患者发生CRKP感染,主要为呼吸道感染、血流感染以及腹腔感染。环境监测显示,131份环境物体表面和工作人员手标本仅有2份标本检出CRKP,经PFGE鉴定显示2株分离自洗手池水槽标本的CRKP与2例近期住院患者检出的菌株高度同源。另有部分患者分离菌株同源性较高,存在交叉传播的可能。结论 CRKP容易在ICU患者之间交叉传播并污染环境,应早期对其进行预警和调查,以防医院感染暴发事件的出现。

    Abstract:

    Objective To investigate a cluster of healthcare-associated infection (HAI) of carbapenem-resistant Klebsiella pneumoniae (CRKP) in intensive care unit (ICU) of a traditional Chinese medicine hospital, and provide evidence for the prevention and control of multidrug-resistant organisms in hospitals. Methods From January to July 2023, multiple cases of CRKP infection in the ICU of a traditional Chinese medicine hospital occurred, surpassing the number in the same period of previous years. Through collection of patients’ clinical information, epidemiological investigation and environmental hygiene monitoring, the isolated CRKP strains were identified by pulsed-field gel electrophoresis (PFGE), possible causes of transmission were found out, and corresponding control measures were taken. Results During the study period, a total of 13 patients were confirmed to have developed CRKP infection, mainly respiratory tract infection, bloodstream infection, and abdominal infection. Environmental monitoring showed that only 2 out of 131 environmental object surfaces specimens and staff’s hand specimens tested positive for CRKP. PFGE identification showed that the 2 CRKP strains isolated from the sink specimens were highly homologous to the strains isolated from 2 recently admitted patients. Some strains isolated from patients were highly homologous, indicating a possibility of cross transmission. Conclusion CRKP is prone to be cross-transmission among ICU patients and contaminates the environment. Early warning and investigation should be conducted to prevent the occurrence of HAI outbreaks.

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霍嫚,徐文娟,王芳,等.一起耐碳青霉烯类肺炎克雷伯菌聚集事件的调查与分析[J]. 中国感染控制杂志,2025,24(1):93-98. DOI:10.12138/j. issn.1671-9638.20257107.
HUO Man, XU Wenjuan, WANG Fang, et al. Investigation and analysis of a cluster event of carbapenem-resistant Klebsiella pneumoniae[J]. Chin J Infect Control, 2025,24(1):93-98. DOI:10.12138/j. issn.1671-9638.20257107.

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  • 收稿日期:2024-10-24
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  • 在线发布日期: 2025-01-24
  • 出版日期: 2025-01-28