北部某醫學中心內科加護病房泛抗藥性綠膿桿菌群突發之調查報告

The Outbreak of Pan-drug Resistant Pseudomonas Aeruginosa in a Medical Intensive Care Unit of Medical Center in Northern Taiwan

姜秋芬(Chiu-Fen Chiang) ； 劉昌邦(Chang-Pan Liu) ； 王乃玉(Nai-Yu Wang) ； 李聰明(Chun-Ming Lee)

《內科學誌》 16卷2期 (2005/04) Pp. 84-90

https://doi.org/10.6314/JIMT.2005.16(2).04

摘要

Pseudomonas aeruginosa is well recognized as a nosocomial pathogen, and has inherent drug resistance. Compared with community-acquired strains, nosocomially acquired Pseudomonas aeruginosa isolates tend to be more resistant (of ten, to multiple classes of antibiotics). In a medical intensive care unit of a medical center in the northern Taiwan, the number of the cases of PDRPA infections and colonization has apparently increased since November, 2003, if compared with the number of those from January, 2003 to October, 2003. From November, 2003 to January, 2004, six PDRPA-infected cases were enrolled in the study according to the standard definition of nosocomial infection. By means of chi-square, the above cases were regarded as meaningful (p＜0.05) in statistics and therefore this led to suspicion of the outbreak infection. The situation was immediately investigated and handled, and specimens were taken from environment on January 30, 2003. Among them, one positive specimen with the most infectious meaning was selected to be analyzed by pulsed field gel electrophoresis (PFGE), together with 43 PDRPA specimens from the medical intensive care unit. The two kinds of specimens were also compared by DNA fragments. Number of different bands less than 3 was found between the positive specimen from environment and 18 specimens from patients. The result showed there was high relevance between the two kinds of isolates. Thus the outbreak of nosocomial infection was confirmed. Because the infection source and transmission route were fully understood, so the infection control measures were well reinforced and the outbreak was soon under control.

關鍵字

綠膿桿菌 ； 群突發

並列摘要

Pseudomonas aeruginosa is well recognized as a nosocomial pathogen, and has inherent drug resistance. Compared with community-acquired strains, nosocomially acquired Pseudomonas aeruginosa isolates tend to be more resistant (of ten, to multiple classes of antibiotics). In a medical intensive care unit of a medical center in the northern Taiwan, the number of the cases of PDRPA infections and colonization has apparently increased since November, 2003, if compared with the number of those from January, 2003 to October, 2003. From November, 2003 to January, 2004, six PDRPA-infected cases were enrolled in the study according to the standard definition of nosocomial infection. By means of chi-square, the above cases were regarded as meaningful (p＜0.05) in statistics and therefore this led to suspicion of the outbreak infection. The situation was immediately investigated and handled, and specimens were taken from environment on January 30, 2003. Among them, one positive specimen with the most infectious meaning was selected to be analyzed by pulsed field gel electrophoresis (PFGE), together with 43 PDRPA specimens from the medical intensive care unit. The two kinds of specimens were also compared by DNA fragments. Number of different bands less than 3 was found between the positive specimen from environment and 18 specimens from patients. The result showed there was high relevance between the two kinds of isolates. Thus the outbreak of nosocomial infection was confirmed. Because the infection source and transmission route were fully understood, so the infection control measures were well reinforced and the outbreak was soon under control.

並列關鍵字

Pseudomonas aeruginosa ； Outbreak