肺炎克雷伯菌感染暴发控制(翻译有奖）
Successful Control of an Outbreak of Klebsiella pneumoniae Carbapenemase–Producing K. pneumoniae at a Long-Term Acute Care HospitalInfect Control Hosp Epidemiol 2010;31:341–347
Objective.To determine the effect of a bundle of infection control interventions on the horizontal transmission of Klebsiella pneumoniae carbapenemase (KPC)–producing K. pneumoniae during an outbreak.
Design.Quasi-experimental study.
Setting.Long-term acute care hospital.
Intervention.On July 23, 2008, a bundled intervention was implemented: daily 2% chlorhexidine gluconate baths for patients, enhanced environmental cleaning, surveillance cultures at admission, serial point prevalence surveillance (PPS), isolation precautions, and training of personnel. Baseline PPS was performed before the intervention was implemented. Any gram-negative rod isolate suspected of KPC production underwent a modified Hodge test and, if results were positive, confirmatory polymerase chain reaction testing. Clinical cases were defined to occur for patients whose samples yielded KPC-positive gram-negative rods in clinical cultures.
Results.Baseline PPS performed on June 17, 2008, showed a prevalence of colonization with KPC-producing isolates of 21% (8 of 39 patients screened). After implementation of the intervention, monthly PPS was performed 5 times, which showed prevalences of colonization with KPC-producing isolates of 12%, 5%, 3%, 0%, and 0% ( ). From January 1, 2008, until the intervention, 8 KPC-positive clinical cases—suspected to be due to horizontal transmission—were detected. From implementation of the intervention through December 31, 2008, only 2 KPC-positive clinical cases, both in August 2008, were detected. From January 1 through December 31, 2008, 8 patients were detected as carriers of KPC-producing isolates at admission to the institution, 4 patients before and 4 patients after the intervention.
Conclusion.A bundled intervention was successful in preventing horizontal spread of KPC-producing gram-negative rods in a long-term acute care hospital, despite ongoing admission of patients colonized with KPC producers. 附赠文章全文供大家参考 感谢分享资料，阅读学习了。 急救医院的产碳青霉烯类肺炎克雷伯菌（KPC）感染暴发的控制
感染控制医院流行病学，2010，31（4）：341~347
【目的】探索综合干预措施对KPC感染暴发控制的效果
【设计】类实验（半实验）
【研究对象】专业的急救医院
【干预措施】2008年7月23日采取了一系列的综合干预措施：患者每天2%洗必泰皂液洗澡，提高环境清洁度，监测入院患者特点，不同时点患病率监测（PPS），隔离预防，和医务人员培训。在干预前开展时点患病率基线调查（PPS）。任何疑似KPC革兰阴性菌均进行扩增实验（Hodge实验），如果是阳性，进一步进行PCR测序。结合临床特征和产KPC革兰阳性菌诊断为临床病例。
【结果】2008年6月17开展患病率基线调查表明KPC定植分离率为21%(8/39)。干预后，每月调查患病率共5次，分离率分别为：12%、5%、3%、0%、0%。2008年1月1日到干预时8个KPC阳性病例，可能是由于交叉感染传播，被证实。自从干预后到2008年12月31日，8例检测出KPC阳性的携带者，其中4例以前就存在，4例是干预后检出的
【结论】尽管病人入院时已定植KPC，在急救医院开展综合干预措施对于预防产KPC革兰(氏)阴性杆菌交叉感染仍是有效的。
这么久都没人翻译，有些词专业词汇不会翻译，请大家指正。 underwent a modified Hodge test应该是均进行改良Hodge实验吧
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