RESUMO
Objective To investigate the sources and transmission routes of clustered cases of healthcare-associated infection(HAI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) in the intensive care unit (ICU) of a hospital,and provide evidence for the prevention and control of HAI.Methods Clustered cases of MDR-AB HAI in ICU were investigated,specimens of patients and environment were collected and cultured,the isolated strains were performed antimicrobial susceptibility testing.Results Five strains of pathogenic bacteria were isolated from sputum of patients with HAI,5 infected patients were at adjacent beds from the same ICU;the onset time was on January 2-7,2016.A total of 21 strains of pathogenic bacteria were isolated from environmental specimens during the same period,these strains were from quilt,bedside cabinet,treatment trolley,faucet,bedrail,breathing tube,and hands of health care worker(HCWs).Antimicrobial susceptibility testing results showed that strains from patients and environment were all MDR AB,and had the similar antimicrobial resistance pattern.Conclusion The occurrence of clustered HAI cases is due to contamination of HCWs' hands and hospital environment by MDR-AB.
RESUMO
Objective To study the clinical isolation situation of Enterococcus bacteria and the drug resistance change to provide the basis for guiding clinical rational drug use and controlling infection.Methods The clinical specimens in our hospital from Janu-ary 2008 to June 2013 were performed the routine bacterial culture,identification and drug sensitivity test.The WHONET 5.6 soft-ware was used to analyze the distribution of the clinical Enterococcus bacteria l isolates in various samples and the departments and the drug resistance change during this period.Results Total 420 strains of Enterococcus bacteria were isolated during this period, including 288 strains of E.faecium(68.6%),128 strains of E.faecalis(30.5%),3 strains of E.gallinarum(0.7%)and 1 strain of E.casseliflavus(0.2%).The Enterococcus bacteria isolates were mainly distributed in urine(60.5%),wound secretion(20.0%) and blood(13.6%).The large changes occurred in the strains and drug-resistance of isolated Enterococcus bacteria during this peri-od.The proportion of E.faecium maintained about 65% every year.The proportion of E.faecalis was about 35%.The resistance rate of E.faecium to ampicillin,penicillin and nitrofurantoin was significantly higher than that of E.faecalis .Its resistance rates to penicillin,tetracycline,nitrofurantoin,high concentration gentamycin,high concentration streptomycin,ciprofloxacin and ampicillin were close to or over 70%.Total 3 strains of vancomycin-resistant E.faecium were isolated,including 2 strains in 2008 and 1 strain in 2009.Total 13 strains of vancomycin-intermediate E.faecalis were isolated,including 1 strain in 2008,5 strains in 2009 and 7 strains in 2010.Conclusion The drug resistance of Enterococcus bacteria is very serious and the drug resistance of different strains is different.The clinical anti-infection should rationally select the antibacterial drugs for increasing the curative effects according to the in vitro susceptibility of the isolated strains to the bacterial drugs.