Abstract:
OBJECTIVE To analyze the reasons for the outbreak of suspected carbapenem-resistant Acinetobacter baumannii(CRAB) infections in the neurosurgical intensive care unit to take comprehensive prevention and control measures to control the spread of infections, and to provide a reference for the control of multidrug-resistant organisms (MDRO) infections in intensive care units.
METHODS Epidemiological data were collected from five patients with CRAB infections in the neurosurgical intensive care unit of Gansu Provincial People′s Hospital in Mar.2024, and environmental hygiene monitoring and comprehensive infection prevention and control measures were conducted.
RESULTS A total of five cases of lower respiratory tract infections occurred, all of which were hospital-acquired infections, and all patients had consistent spatial-temporal distribution.A.baumannii was detected in the sputum cultures of all patients, and all were resistant to carbapenems, aminoglycosides and some β-lactam drugs.Before the implementation of comprehensive prevention and control measures, a total of 25 samples from the surfaces and the hands of health workers were collected, with a pass rate of 52.00%;CRAB was detected on the surface of treatment carts and the wall of sputum suction bottles in the treatment room, with a detection rate of 8.00%.After the implementation, a total of 24 samples were collected, with a pass rate of 100.00%, and the difference was statistically significant when compared with the pre-implementation period (χ2=16.987, P < 0.001).Through the implementation of comprehensive measures such as isolation, standardization of the ward cleaning and disinfection process, strengthening hand hygiene, standardization of sterile operations and personnel management, the indicators such as hand hygiene compliance rate, the execution rate of multi-drug-resistant bacterial preventive and control measures and the fluorescent marker removal rate were all improved, and the suspected CRAB infection outbreak was timely controlled.
CONCLUSION This suspected CRAB hospital-acquired infection outbreak may be related to a variety of factors, and timely environmental hygiene monitoring and comprehensive infection prevention and control measures can effectively control the spread of CRAB infection.