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摘要:
背景:电脑键盘和鼠标是院内病原体潜在的附着体,但常规消毒对于防水的电脑设备来说可能无济于事。依靠良好的手卫生习惯,能否降低这些污染源对临床感染的影响呢?
方法:本次研究在台湾南部的拥有1600床位的医疗中心内展开,其中含有47个病房和282台电脑。在对医务人员进行了手卫生教育和监测后,得到了本院手卫生的平均依从性为74%。我们通过PFGE和药敏谱调查分析了来自键盘、鼠标的分离株及非感染暴发时的临床分离株,主要MRSA,铜绿假单胞菌和鲍曼不动杆菌等三大院内获得性病原菌。
结果:结果表明电脑设备上的金黄色葡萄球菌,鲍曼不动杆菌和铜绿假单胞菌的污染率达到17.4%。MRSA和鲍曼不动杆菌在病房中电脑的污染率为1.1%和4.3%,但未分离到铜绿假单胞菌。所有来自同一病房的电脑和临床分离株显示出不同的型别。然而,有2个病房的电脑上分离到的鲍曼不动杆菌为同一型。
结论:依靠良好的手卫生依从性,我们发现MRSA,铜绿假单胞菌和鲍曼不动杆菌在病房电脑的污染率明显降低,并且没有造成内院感染。我们的研究结果提示在无院内感染暴发的情况下,常规消毒甚至电脑设备上的微生物监测不应该强制执行。
Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii on computer interface surfaces of hospital wards and association with clinical isolates (BMC Infectious Diseases.2009.10)
Po-Liang Lu,L. k Siu,Tun-Chieh Chen,et al.
Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan
Abstract
Background: Computer keyboards and mice are potential reservoirs of nosocomial pathogens, but routine disinfection for non-water-proof computer devices is a problem.With better hand hygiene compliance of health-care workers (HCWs), the impact of
these potential sources of contamination on clinical infection needs to be clarified.
Methods: This study was conducted in a 1600-bed medical center of southern Taiwan with 47 wards and 282 computers. With education and monitoring program of hand hygiene for HCWs, the average compliance rate was 74% before our surveillance. We
investigated the association of methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Acinetobacter baumannii, three leading hospital-acquired pathogens, from ward computer keyboards, mice and from clinical isolates in non-outbreak period by pulsed field gel electrophoresis and antibiogram.
Results: Our results revealed a 17.4% (49/282) contamination rate of these computer devices by S. aureus, Acinetobacter spp. or Pseudomonas spp. The contamination rates of MRSA and A. baumannii in the ward computers were 1.1% and 4.3%,respectively. No P. aeruginosa was isolated. All isolates from computers and clinical specimens at the same ward showed different pulsotypes. However, A. baumannii isolates on two ward computers had the same pulsotype.
Conclusion: With good hand hygiene compliance, we found relatively low contamination rates of MRSA, P. aeruginosa and A. baumannii on ward computer interface, and without further contribution to nosocomial infection. Our results suggested no
necessity of routine culture surveillance in non-outbreak situation. |
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