Chinese Journal of Emergency and Critical Care Nursing >
Survey on distribution characteristics of carbapenem-resistant organism in intensive care units of different specialties
Received date: 2024-09-12
Online published: 2025-04-28
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.
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 . DOI: 10.3761/j.issn.2096-7446.2025.05.003
[1] | Mancuso G, De Gaetano S, Midiri A, et al. The challenge of overcoming antibiotic resistance in carbapenem-resistant gram-negative bacteria:“attack on titan”[J]. Microorganisms, 2023, 11(8):1912. |
[2] | 何江娟, 瞿婷婷. 重症监护病房多重耐药菌感染风险预测模型研究进展[J]. 中华临床感染病杂志, 2023, 16(5):384-390. |
He JJ, Qu TT. Research progress of risk prediction model of multidrug-resistant bacteria infection in ICU patients[J]. Chin J Clin Infect Dis, 2023, 16(5):384-390. | |
[3] | Weiner LM, Webb AK, Limbago B, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections:summary of data reported to the national healthcare safety network at the centers for disease control and prevention,2011-2014[J]. Infect Control Hosp Epidemiol, 2016, 37(11):1288-1301. |
[4] | CHINET中国细菌耐药监测网. CHINET数据云/抗生素耐药性[EB/OL]. (2024-01-22)[2024-09-08]. https://www.chinets.com/Data/AntibioticDrugFast. |
CHINET Bacterial Resistance Surveillance Network. CHINET data cloud/antibiotic resistance[EB/OL]. (2024-01-22)[2024-09-08]. https://www.chinets.com/Data/AntibioticDrugFast. | |
[5] | 吕海超, 赵娜, 窦红威. 重症监护室患者多重耐药菌感染状况及危险因素分析[J]. 中国实用医刊, 2021, 48(4):82-85. |
Lü HC, Zhao N, Dou HW. Multi-drug resistant bacterial infection and its risk factors in patients in intensive care unit[J]. Chin J Pract Med, 2021, 48(4):82-85. | |
[6] | Publications Office of the European Union. Antimicrobial resistance surveillance in Europe 2023[EB/OL]. (2023-06-12)[2024-09-08]. https://op.europa.eu/en/publication-detail/-/publication/97ee4ab5-0994-11ee-b12e-01aa75ed71a1/language-en. |
[7] | 陈美恋, 王守军, 匡季秋, 等. 某院2016—2018年ICU多重耐药菌医院感染特点分析[J]. 中国护理管理, 2019, 19(12):1877-1880. |
Chen ML, Wang SJ, Kuang JQ, et al. Characteristic of hospital-associated infection in ICU with multidrug-resistant organisms in a hospital from 2016 to 2018[J]. Chin Nurs Manag, 2019, 19(12):1877-1880. | |
[8] | Vincent JL, Rello J, Marshall J, et al. International study of the prevalence and outcomes of infection in intensive care units[J]. JAMA, 2009, 302(21):2323-2329. |
[9] | Nordmann P, Gniadkowski M, Giske CG, et al. Identification and screening of carbapenemase-producing Enterobacteriaceae[J]. Clin Microbiol Infect, 2012, 18(5):432-438. |
[10] | 余跃天, 马朋林. 重症监护病房多重耐药菌防控:指南与实践[J]. 中华医学杂志, 2019, 99(25):1945-1948. |
Yu YT, Ma PL. Prevention and control of multidrug-resistant organisms:guidelines vs practice[J]. Natl Med J China, 2019, 99(25):1945-1948. | |
[11] | 黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识[J]. 中国感染控制杂志, 2015, 14(1):1-9. |
Huang X, Deng ZD, Ni YX, et al. Chinese experts’ consensus on prevention and control of multidrug resistance organism healthcare-associated infection[J]. Chin J Infect Contr, 2015, 14(1):1-9. | |
[12] | 国家卫生健康委员会. 碳青霉烯类耐药肠杆菌预防与控制标准WS/T 826—2023[J]. 中国感染控制杂志, 2023, 22(10):1274-1278. |
National Health Commission. Standard for infection prevention and control of carbapenem-resistant Enterobacterales WS/T 826-2023[J]. Chin J Infect Contr, 2023, 22(10):1274-1278. | |
[13] | Liu H, Huang B. Basic situation and prevention and control measures of hospital acquired infections caused by multidrug-resistant bacteria in ICU patients[J]. Adv Clin Med, 2024, 14(2):2627-2634. |
[14] | 中华预防医学会医院感染控制分会, 中华医学会感染病学分会, 中国医院协会医院感染管理专业委员会, 等. 中国碳青霉烯耐药革兰阴性杆菌(CRO)感染预防与控制技术指引[J]. 中华医院感染学杂志, 2019, 29(13):2075-2080. |
Hospital Infection Control Branch of Chinese Preventive Medicine Association,Infectious Diseases Branch of Chinese Medical Association, Hospital Infection Management Profes-sional Committee of Chinese Hospital Association, et al. Technical guidelines for prevention and control of carbapenem-resistant gram-negative bacilli infection in China[J]. Chin J Nosocomiology, 2019, 29(13):2075-2080. | |
[15] | Nakayama A, Yamaguchi I, Okamoto K, et al. Targeted infection control practices in Japanese hospitals for multidrug-resistant organisms:guidance from the public health center[J]. Cureus, 2023, 15(12):e50680. |
[16] | World Health Organization. Antimicrobial resistance[EB/OL]. (2023-11-21)[2024-09-08]. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance |
[17] | Yi J, Kim KH. Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units[J]. Acute Crit Care, 2021, 36(3):175-184. |
[18] | Snyder GM, Wright SB. The role of environmental contamination in the transmission of nosocomial pathogens[J]. Curr Opin Infect Dis, 2013, 26(4):338-344. |
[19] | World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae,Acinetobacter baumannii,and Pseudomonas aeruginosa in health care facilities[M]. Geneva: World Health Organization,2017,51. ISBN 978-92-4-155017-8. |
[20] | Oremade O, Odac B, George J, et al. The impact of a novel color additive for disinfectant wipes on room cleanliness and turnover time[J]. Am J Infect Contr, 2024, 52(12):1366-1370. |
/
〈 |
|
〉 |