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目的调查新生儿科产超广谱β-内酰胺酶(ESBL)细菌感染情况,查找传染源和传播途径,采取有效的预防控制措施,减少医院感染。方法 2012年2月16日-26日新生儿科病房发生6例产ESBL细菌感染病例,按照医院感染暴发处理流程,对疑似医院感染暴发患儿进行现场流行病学调查,主要方法包括查看病历、询问负责医生患儿临床症状、采集患儿痰标本和环境微生物采样等。结果发现4例患儿为社区感染,2例患儿为医院感染;感染病例发病时间集中(2012年2月16日-26日);患儿临床症状相似,出现发热、咳嗽、咯痰等,体征为肺部湿啰音等下呼吸道感染症状;从感染患儿痰标本分离出6株产ESBL大肠埃希菌且药物敏感性试验报告不完全一致,不属于同种同源的病原菌;床旁调查:从环境标本中分离出6株产ESBL细菌,来源分别为患儿所在病区的配奶间台面、水壶、呼吸机管路、医生鼻腔、保洁工鼻腔。结论该次感染不属于医院感染暴发,而是产ESBL大肠埃希菌感染聚集事件。患儿出现感染症状,主要是由于患儿本身免疫力较低,及新生儿科的无菌技术以及消毒隔离措施管理不到位,因此要加强医务人员手卫生管理,定期做好环境卫生消毒,以降低新生儿医院感染的发生。
Objective To investigate the bacterial infection of extended-spectrum β-lactamase (ESBL) in neonates, search for sources of infection and transmission routes, and take effective prevention and control measures to reduce nosocomial infections. Methods Six cases of ESBL-producing bacterial infections occurred in the neonatal ward from February 16 to February 26, 2012. According to the nosocomial outbreak treatment procedures, an on-site epidemiological survey was conducted on suspected outbreaks of nosocomial infections in hospitals. The main methods include checking medical records and asking Responsible for the clinical symptoms of children with children, collecting sputum samples of children and environmental microbiological sampling. The results showed that 4 cases of children with community-acquired infection, 2 cases of hospital infection; the incidence of infectious cases concentrated (February 16, 2012 -26); children with similar clinical symptoms, fever, cough, expectoration, etc., Signs of pulmonary rales and other symptoms of lower respiratory tract infection; sputum from children with sputum isolated from 6 strains of ESBL-producing Escherichia coli and the drug sensitivity test reports are not identical, does not belong to the same homologous pathogenic bacteria; bedside Investigation: Six strains of ESBL-producing bacteria were isolated from environmental samples. The sources were the milk table, water bottle, ventilator pipeline, doctor’s nasal cavity and cleaner’s nasal cavity. Conclusion The infection is not a nosocomial infection outbreak, but ESBL-producing Escherichia coli infection aggregation events. Symptoms of infection in children, mainly due to children with low immunity, and neonatal sterile technology and disinfection and isolation measures management is not in place, so to strengthen medical staff hand hygiene management, regular sanitation and disinfection to reduce Neonatal hospital infection.