细菌可能一直在手套上并转移到其它表面


  【24drs.com】根据一篇新研究结果,医院伺机感染,包括呼吸机相关肺炎的常见原因:鲍氏不动杆菌(Acinetobacter baumannii)-喜欢潮湿的一种细菌,可以很容易地从检查用手套转移到塑料表面上。
  
  日本文京日本医学院的Kazue Fujita医师等人报告指出,鲍氏不动杆菌似乎对检查用手套和聚丙烯材质塑料有特定亲和力。
  
  Fujita医师指出,虽然长袍和手套可保护医护人员和患者免于感染传播,但无法移除或改变受污染的手套增加传播之可能性,特别是有足够耐力在医院环境物品表面存活的细菌。
  
  她在2016年美国微生物协会(American Society for Microbiology,ASM)会议中简报时表示,改善使用手套之合规性将减少医疗保健相关感染的风险,同样重要的是,建立针对各个[类型]细菌之基础风险评估和管理方法。
  
  Fujita医师等人进行研究,探讨有哪里些与有多少细菌会从受污染的手套传播到医院环境内的物品表面。
  
  他们将一些与医疗照护相关感染有关的常见细菌,如多重抗药性大肠杆菌、克雷伯氏肺炎菌、鲍氏不动杆菌以及绿脓杆菌,接种在丁腈检查用手套。
  
  这些手套分别被接种每10 μL含105、103与10个菌落形成单位的各种细菌,然后在接种后立即、接种后30秒与3分钟(手套表面完全干燥后)时,将这些受污染的手套与无菌的聚丙烯表面接触,研究者接著量化在聚丙烯表面存活的各细菌数量。
  
  接种后立即接触,接种的所有细菌各有5%至10%被传播到聚丙烯表面,不过,除了鲍氏不动杆菌,其它所有细菌的量都随著时间降低,接种后3分钟时,在聚丙烯表面无法测得。
  
  分离这些持续存在的鲍氏不动杆菌发现,药物敏感性与多重抗药性菌株都有。
  
  研究者表示,他们观察到的这种容易传播的情况,或许可以解释出现多重抗药性鲍氏不动杆菌的原因,这些菌株的传播风险因素包括伤口处理和人工呼吸道。Kazue医师报告指出,这些微小的细菌也很持久,在受感染患者出院后9天还可在其病床护栏分离到这个菌。
  
  未参与此研究的南卡罗来纳医学大学Michael Schmidt博士表示,这篇研究显示细菌比人们更喜欢的一件东西就是塑料。
  
  他表示,这项研究的结果,虽然不是预期的,但是显著的,因为它们提供了一些手套对医疗保健有显著风险的第一手数据。
  
  人们应该知道的,但是本研究未包含的一件事情是,医院内的其它许多工作同仁,特别是环境服务相关单位者,并未经常更换他们的手套。
  
  资料来源:http://www.24drs.com/
  
  Native link:Bacteria Can Persist on Gloves, Transfer to Surfaces

Bacteria Can Persist on Gloves, Transfer to Surfaces

By Neil Osterweil
Medscape Medical News

BOSTON — Acinetobacter baumannii, a moisture-loving bug that is a common cause of opportunistic infections in hospitals, including ventilator-associated pneumonia, can easily be transferred from examination gloves to plastic surfaces, according to the results of a new study.

A baumannii seems to have a particular affinity for exam gloves and polypropylene plastics, report Kazue Fujita, MD, from Nippon Medical School in Bunkyo, Japan, and colleagues.

Although gowns and gloves protect healthcare workers and patients from transmission of infectious organisms, failure to remove or change contaminated gloves increases the likelihood of transmission, especially when microorganisms are hardy enough to survive on hospital surfaces, Dr Fujita added.

"Improving glove use compliance will decrease the risk of healthcare-associated infections. It is also important to establish a basis for a risk assessment and a management approach to each [type of] bacteria," she said at a briefing here at the American Society for Microbiology (ASM) Microbe 2016.

Dr Fujita and colleagues conducted a study to see how many and what types of common bacteria could be transmitted from contaminated gloves to hospital surfaces.

They inoculated nitrile examination gloves with bacteria commonly found in healthcare-associated infections, including multidrug-resistant strains of Escherichia coli, Klebsiella pneumonia, A baumannii, and Pseudomonas aeruginosa.

The gloves were inoculated with 105, 103, and 10 colony forming units/10 μL of each microorganism. The contaminated gloves were then touched to a sterilized polypropylene surface immediately, at 30 seconds, and at 3 minutes (after the glove's surface had completely dried). The investigators then quantified the number of viable bacteria on the polypropylene surface.

From 5% to 10% of all bacteria from the inoculated gloves was transmitted to the polypropylene surface immediately after inoculation. However, all tested microorganisms except A baumannii decreased in a dose- and time-dependent fashion, and could not be detected on the polypropylene surface 3 minutes after inoculation.

The persistent A baumannii isolates included both a drug-sensitive and a multidrug-resistant strain.

The investigators say that the ease of transmission they observed may explain the emergence of multidrug-resistant A baumannii. Risk factors for transmission of these strains included wound manipulation and artificial airways. The little bugs are also durable, and have been isolated from bed rails up to 9 days after an infected patient was discharged, Dr Kazue reported.

The study shows that "the only thing that bacteria love more than people is plastic," said Michael Schmidt, PhD, from the Medical University of South Carolina in Charleston, who was not involved in the study.

"The findings of this study, while not unanticipated, are significant in that they provide some of the first data on the significant risk that gloves represent to healthcare," he told Medscape Medical News.

"One of the things not in the study that people should be aware about is that many of the other workers in the hospital, principally the environmental services team, don't often change their gloves."

The study was supported by Bunkyo Gakuin University and the Nippon Medical School. The investigators and Dr Schmidt have disclosed no relevant financial relationships.

American Society for Microbiology (ASM) Microbe 2016: Abstract 333. Presented June 19, 2016.

    
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