病人鼻腔及肛門拭子培養應用於篩檢carbapenem-resistant Acinetobacter baumannii移生狀況的效果評估

Assessing the Utility of Anal and Nasal Swabs for the Screening of Carbapenem-Resistant "Acinetobacter baumannii" Colonization

10.6526/ICJ.201404_24(2).0001

賴美珠(Mei-Chu Lai)；許國忠(Gwo-Jong Hsu)

carbapenem-resistant Acinetobacter baumannii篩檢 ； 鼻腔拭子 ； 肛門拭子 ； carbapenem-resistant "Acinetobacter baumannii" ； screening ； nasal cavity swabs ； anal swab

感染控制雜誌

24卷2期（2014 / 04 / 01）

57 - 64

繁體中文

”Acinetobacter baumannii” usually contaminates the hospital environment as well as the hands and clothes of healthcare workers. In addition, it can accidentally result in an outbreak of infection. The current clinical practice for patients with carbapenem-resistant ”A. baumannii” (CRAB) is care in an isolation room with screening, which is continued until the screening results become negative. However, at present, no consensus has been reached regarding the most suitable screening method. In this study, we reviewed the records of 127 in-patients who underwent clinical specimen isolation for CRAB at the Chia-Yi Christian Hospital during 2010-2011. The assessment of the initial screening results revealed that the positive rate for nasal cavity swabs was significantly higher than that for anal swabs (61.4% and 20.5%, respectively, P ＜ 0.0001). Therefore, to reduce screening costs and laboratory effort, it was suggested that the original infection site as well as anal and nasal cavities be tested only during the initial screening. If the results of the initial anal cavity screening were negative, it was not subsequently screened; only the nasal cavity and the original infected sites were tested further. Furthermore, isolation measures were discontinued when the results of 2 consecutive screenings of these 2 sites were negative.

”Acinetobacter baumannii” usually contaminates the hospital environment as well as the hands and clothes of healthcare workers. In addition, it can accidentally result in an outbreak of infection. The current clinical practice for patients with carbapenem-resistant ”A. baumannii” (CRAB) is care in an isolation room with screening, which is continued until the screening results become negative. However, at present, no consensus has been reached regarding the most suitable screening method. In this study, we reviewed the records of 127 in-patients who underwent clinical specimen isolation for CRAB at the Chia-Yi Christian Hospital during 2010-2011. The assessment of the initial screening results revealed that the positive rate for nasal cavity swabs was significantly higher than that for anal swabs (61.4% and 20.5%, respectively, P ＜ 0.0001). Therefore, to reduce screening costs and laboratory effort, it was suggested that the original infection site as well as anal and nasal cavities be tested only during the initial screening. If the results of the initial anal cavity screening were negative, it was not subsequently screened; only the nasal cavity and the original infected sites were tested further. Furthermore, isolation measures were discontinued when the results of 2 consecutive screenings of these 2 sites were negative.