細菌可能一直在手套上並轉移到其他表面


  【24drs.com】根據一篇新研究結果,醫院伺機感染,包括呼吸機相關肺炎的常見原因:鮑氏不動桿菌(Acinetobacter baumannii)-喜歡潮濕的一種細菌,可以很容易地從檢查用手套轉移到塑膠表面上。
  
  日本文京日本醫學院的Kazue Fujita醫師等人報告指出,鮑氏不動桿菌似乎對檢查用手套和聚丙烯材質塑膠有特定親和力。
  
  Fujita醫師指出,雖然長袍和手套可保護醫護人員和患者免於感染傳播,但無法移除或改變受汙染的手套增加傳播之可能性,特別是有足夠耐力在醫院環境物品表面存活的細菌。
  
  她在2016年美國微生物協會(American Society for Microbiology,ASM)會議中簡報時表示,改善使用手套之合規性將減少醫療保健相關感染的風險,同樣重要的是,建立針對各個[類型]細菌之基礎風險評估和管理方法。
  
  Fujita醫師等人進行研究,探討有哪些與有多少細菌會從受汙染的手套傳播到醫院環境內的物品表面。
  
  他們將一些與醫療照護相關感染有關的常見細菌,如多重抗藥性大腸桿菌、克雷伯氏肺炎菌、鮑氏不動桿菌以及綠膿桿菌,接種在丁腈檢查用手套。
  
  這些手套分別被接種每10 μL含105、103與10個菌落形成單位的各種細菌,然後在接種後立即、接種後30秒與3分鐘(手套表面完全乾燥後)時,將這些受汙染的手套與無菌的聚丙烯表面接觸,研究者接著量化在聚丙烯表面存活的各細菌數量。
  
  接種後立即接觸,接種的所有細菌各有5%至10%被傳播到聚丙烯表面,不過,除了鮑氏不動桿菌,其他所有細菌的量都隨著時間降低,接種後3分鐘時,在聚丙烯表面無法測得。
  
  分離這些持續存在的鮑氏不動桿菌發現,藥物敏感性與多重抗藥性菌株都有。
  
  研究者表示,他們觀察到的這種容易傳播的情況,或許可以解釋出現多重抗藥性鮑氏不動桿菌的原因,這些菌株的傳播風險因素包括傷口處理和人工呼吸道。Kazue醫師報告指出,這些微小的細菌也很持久,在受感染患者出院後9天還可在其病床護欄分離到這個菌。
  
  未參與此研究的南卡羅來納醫學大學Michael Schmidt博士表示,這篇研究顯示細菌比人們更喜歡的一件東西就是塑膠。
  
  他表示,這項研究的結果,雖然不是預期的,但是顯著的,因為它們提供了一些手套對醫療保健有顯著風險的第一手數據。
  
  人們應該知道的,但是本研究未包含的一件事情是,醫院內的其他許多工作同仁,特別是環境服務相關單位者,並未經常更換他們的手套。
  
  資料來源: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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