初探醫院環境對醫療人員胃腸道Escherichia coli的抗藥性影響

The Effect of Hospital Environments on the Incidence of Antibiotic-resistant Escherichia coli in Fecal Samples of Health-care Workers

呂春美(Chun-Mei Lu) ； 張進祿(Chin-Lu Chang) ； 馬怡汝(Yi-Ru Ma) ； 楊致豪(Chih-HaoYang) ； 池麗寬(Li-Kuan Chin) ； 張文瀚(Bruno Man-Hon Cheung) ； 張國寬(Kuo-Kuan Chang) ； 戴芳楟(Fang-Ting Tai) ； 洪慶宣(Ching-Yi Horng)

《感染控制雜誌》 18卷3期 (2008/06) Pp. 137-145

https://doi.org/10.6526/ICJ.200806_18(3).0001

摘要

The aim of this research is to study whether the antibiotic-resistant bacteria in hospital environment can cause potential health threat to health-care workers. Based on the information of the long-term nosocomial infection survey in hospital, we chose medical intensive care unit (MICD) and Escherichia coli as our research place and indicator bacteria. Swab samples from hospital environments, fecal samples from health-care workers and clinical patients were collected to isolate the antibiotic-resistant E. coli. We chose gentamicin, amikacin, the first-, second- and third-generation cephalosporins, fluoroquinolone, and trimethoprim-sulfamethoxazole as the tested antibiotics. Comparing 31 samples from environments with 38 samples from clinical patients, there were significant differences on E.coli resistance rate to gentamicin and the first-, second- and third-generation cephalosporins (p＜0.05). Forty-one samples from health-care workers had, a significantly different pattern of antibiotic resistance, compared to those from environments and clinical patients (p＜0.05). Comparing 29 fecal samples from MICU workers with 12 fecal samples from non-MICU workers, there was no significant difference on E. coli resistance to any tested antibiotics. Therefore, we have reached two preliminary conclusions. First, the antibiotic-resistant E. coli do exist in the hospital environments, even in some areas presumably are clean. The finding may alert the hospital executives to pay more attention to the environmental cleaning and disinfection. Second, exposure to antibiotic-resistant bacteria in the hospital environments would not cause health-care workers acquiring antibiotic-resistant E.coli in their gastrointestinetract.

關鍵字

醫院環境 ； 大腸桿菌 ； 抗藥性

並列摘要

The aim of this research is to study whether the antibiotic-resistant bacteria in hospital environment can cause potential health threat to health-care workers. Based on the information of the long-term nosocomial infection survey in hospital, we chose medical intensive care unit (MICD) and Escherichia coli as our research place and indicator bacteria. Swab samples from hospital environments, fecal samples from health-care workers and clinical patients were collected to isolate the antibiotic-resistant E. coli. We chose gentamicin, amikacin, the first-, second- and third-generation cephalosporins, fluoroquinolone, and trimethoprim-sulfamethoxazole as the tested antibiotics. Comparing 31 samples from environments with 38 samples from clinical patients, there were significant differences on E.coli resistance rate to gentamicin and the first-, second- and third-generation cephalosporins (p＜0.05). Forty-one samples from health-care workers had, a significantly different pattern of antibiotic resistance, compared to those from environments and clinical patients (p＜0.05). Comparing 29 fecal samples from MICU workers with 12 fecal samples from non-MICU workers, there was no significant difference on E. coli resistance to any tested antibiotics. Therefore, we have reached two preliminary conclusions. First, the antibiotic-resistant E. coli do exist in the hospital environments, even in some areas presumably are clean. The finding may alert the hospital executives to pay more attention to the environmental cleaning and disinfection. Second, exposure to antibiotic-resistant bacteria in the hospital environments would not cause health-care workers acquiring antibiotic-resistant E.coli in their gastrointestinetract.

並列關鍵字

Hospital environment ； Escherichia coli ； antibiotic-resistance