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膀胱鏡檢查導致院內泌尿道感染群突發

An outbreak of Genital-Urinary Tract Nosocomial Infection Caused by Cystoscopy Examination

摘要


OBJECTIVE: To analyze the source of infection for an outbreak of genital-urinary tract nosocomial infection caused by cystoscopy examination, and also provide effective control measures to stop the outbreak. MATERIALS AND METHODS: From August 22 to August 27, our hospital has gathered and labeled 5 urological hospitalized patients to have acquired nosocomial urinary tract infection. From epidemic and pre-epidemic phase of infection course through Chi-squre test, the difference was statistically significant (p<0.05), so , it was considered outbreak event. After analysis and epidemiological investigation, it was found that all of the patients have received extra-corporial shock wave lithotripsy and double j ureteral tube insertion. Through cases had no previous indwelling urethral cathterization, but were screened out from all urine and indwelling catheter tip culture and antibiotic susceptibility pattern, which isolated the same labeled group of multiple drug-resistant Pseudomonas aeruginosa, this was trace from one particular case of renal abscess which have used the same cystoscope as the others. RESULTS: After thorough investigation, it was found out that the source of infection could by due to improper washing and insufficients time of high level disinfectant soaking procedure of the instrument. After this outbreak, a strict supervision of handling of used cystoscope, which include removal of secretion, thorough washing, high level disinfectant soaking for more than 30 minutes, rinsing with aseptic distilled water, and drying procedure were observed before the next patient can to use the instrument. Surveillance for such infection was followed up for 2 months, no additional case of post-operative patient was reported to have acquired the same nosocomial infection. CONCLUSIONS: Nosocomial infection can be resulted from insufficient disinfection for medical equipment and personal mistake. This study have shown that patients get nosocomial infection due to contaminated cystoscopy. We should establish the standard operating procedures and enhance their concept about disinfection in order to reduce such infection.

並列摘要


OBJECTIVE: To analyze the source of infection for an outbreak of genital-urinary tract nosocomial infection caused by cystoscopy examination, and also provide effective control measures to stop the outbreak. MATERIALS AND METHODS: From August 22 to August 27, our hospital has gathered and labeled 5 urological hospitalized patients to have acquired nosocomial urinary tract infection. From epidemic and pre-epidemic phase of infection course through Chi-squre test, the difference was statistically significant (p<0.05), so , it was considered outbreak event. After analysis and epidemiological investigation, it was found that all of the patients have received extra-corporial shock wave lithotripsy and double j ureteral tube insertion. Through cases had no previous indwelling urethral cathterization, but were screened out from all urine and indwelling catheter tip culture and antibiotic susceptibility pattern, which isolated the same labeled group of multiple drug-resistant Pseudomonas aeruginosa, this was trace from one particular case of renal abscess which have used the same cystoscope as the others. RESULTS: After thorough investigation, it was found out that the source of infection could by due to improper washing and insufficients time of high level disinfectant soaking procedure of the instrument. After this outbreak, a strict supervision of handling of used cystoscope, which include removal of secretion, thorough washing, high level disinfectant soaking for more than 30 minutes, rinsing with aseptic distilled water, and drying procedure were observed before the next patient can to use the instrument. Surveillance for such infection was followed up for 2 months, no additional case of post-operative patient was reported to have acquired the same nosocomial infection. CONCLUSIONS: Nosocomial infection can be resulted from insufficient disinfection for medical equipment and personal mistake. This study have shown that patients get nosocomial infection due to contaminated cystoscopy. We should establish the standard operating procedures and enhance their concept about disinfection in order to reduce such infection.

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