2009年10月文章：手卫生依从性与电脑上的MRSA，鲍曼和绿脓污染

clarck7

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.

缭绕

1# clarck7
哪本杂志上的？原文呢？

绿茵场

1# clarck7

谢谢分享，询证医学，很有说服力！
电脑上存在的 危险病原微生物 没有造成医院感染，是因为医务人员无菌操作做得好？！
可以相信医务人员如果没有做好手卫生的话，很容易造成交叉感染的。
不知我院是否存在这种现象哦！

落花生

# clarck7
手卫生的依存性提高，是一个值得庆幸的事情，说明我们的工作没有白做，但还需继续努力。

David

文在此

爱上咖啡

常感谢！有了它希望科里的电脑键盘不再是我整天苦口婆心啰嗦的主角。

控制感染

证医学，很有说服力！提高手卫生依从性需要继续努力！

桃子妖妖

quote]非常感谢！有了它希望科里的电脑键盘不再是我整天苦口婆心啰嗦的主角。
也许非也哦，因为你院医护人员手卫生依从性做得如何是前提哦:P

桃子妖妖

许不光是医院电脑键盘和鼠标如此，医护人员的手机、办公区域电话等等设施，倘若有良好的手卫生依从性，在无医院感染暴发的情况下，常规消毒及常规环境监测都不应该强制执行？从另一侧面反应了执行良好的手卫生的的确很重要。

huanghuimin

常感谢！大陆医院提高手卫生还需继续努力!