不同专科ICU碳青霉烯耐药革兰阴性菌分布特征的调查研究

doi:10.3761/j.issn.2096-7446.2025.05.003

Abstract

Abstract:

Objective To analyze the distribution characteristics of carbapenem-resistant gram-negative organisms （CRO） in ICU wards of different specialties，and to provide a basis for adopting infection control measures with characteristics of specialty diseases. Methods From September 2023 to November 2023，samples were collected from 4 hospital districts，10 specialized ICUs and 6 general wards of a comprehensive tertiary general hospital in Hangzhou，Zhejiang Province. Random samples were collected from nursing staff’s hands and environmental object surfaces. Meropenem was used to screen for CRO strains，and all CRO strains were analyzed for homology. Results A total of 1，170 samples，including 334 hands and 836 surfaces，were collected. A total of 209 CRO strains were detected，with a CRO carriage rate of 17.9%. The burn ICU had the highest carriage rate，accounting for 44.0%. Among them，carbapenem-resistant Acinetobacter baumannii complex，carbapenem-resistant Klebsiella pneumoniae，carbapenem-resistant Enterobacter cloacae，and carbapenem-resistant Pseudomonas aeruginosa accounted for 67.9%，14.8%，11.0%，and 6.2%，respectively. Homology analysis showed clonal transmission of the strains detected in the ICUs，including “hand-to-surface” transmission in three intensive care units，but no interdepartmental or hospital-based transmission was found. Conclusion Different specialized ICUs have carbapenem-resistant Gram-negative bacteria，mainly Acinetobacter baumannii，and clonal transmission of CRO strains within the same ICU unit is more common，including “environment-object-surface” and “hand-object-surface” transmission. This suggests that nursing managers should strengthen the standardized implementation of cluster management of multidrug-resistant bacteria.

Key words: Intensive Care Unit, Carbapenem Resistance, Gram-Negative Organisms, Hospital Infection, Nursing Administration

JIN Dingping, WANG Xuejin, HU Yanyan, WANG Mengmeng, WU Feiyu, YANG Xiaoxuan, LU Qun. Survey on distribution characteristics of carbapenem-resistant organism in intensive care units of different specialties[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(5): 530-535.

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Survey on distribution characteristics of carbapenem-resistant organism in intensive care units of different specialties

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