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Sampling Evaluation of Bioaerosol and Antibiotic-Resistant Characteristics in Intensive Care Unit

机译:重症监护病房的生物气溶胶采样和抗药性抽样评估

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Objective: Our research was based in a medical center's Internal Medicine Intensive Care Unit (MICU) and Surgery Intensive Care Unit (SICU) located in central Taiwan. The research objective focus on the bioaerosols and their antibiotic-resistant characteristics in both MICU and SICU. Methods: Three bioaerosol samplers were utilized (Anderson six-stage, AGI-30, and BioSampler) for sampling before and during patient visiting. Upon acquisition of samples, they were inoculated and cultured on BBL (™)~Trypticase (™)~Soy Agar (with 5% Sheep Blood ) medium for growth. The bacterial colonies were later identified and analyzed for antibiotic-resistant characteristics via BD Phoenix (™)~medium ted microbial identification and susceptibility test analyzer. Results : Research results have showed from the bioaerosol samples acquired within the MICU that dominant concentration of bacteria and fungi were below cut off size of 3.3 urn, and they had high possibility to enter human lung's alveolar regions of the body, thereby causing opportunistic infections. The factor of season and air change rate per hour did not statistically associate with bioaerosol concentration (P>0.05) ; However, factor of patient visiting and temperature, relative humidity during sampling showed statistically agreement with bioaerosol concentration (P<0.001) . In terms of bacterial strain identification, Gram-positive bacteria were mainly isolated with risk group (RG) of II. As for antibiotic-resistant bacteria analysis of MICU, strains were identified 63.5 % that were resistant to National Health Insurance Administration (NHIA) designated first (17 types ) and second (18 types) line antibiotics. This phenomenon could very likely affect the medical staffs working within the hospital environment. Conclusions: As a result, recommendations for MICU ventilation designs should be carefully evaluated for the effectiveness of controlling nosocomial infections as well as proper implementation of personal protective equipment in order to reduce bioaerosol opportunistic infections and harmful exposure effects.
机译:目的:我们的研究基于医疗中心位于台湾中部的内科重症监护病房(MICU)和外科重症监护病房(SICU)。研究目标集中在MICU和SICU中的生物气溶胶及其抗生素抗性特征。方法:在访问病人之前和期间,使用了三个生物气溶胶采样器(安德森六级,AGI-30和BioSampler)进行采样。获得样品后,将它们接种并在BBL(™)〜胰蛋白酶(™)〜大豆琼脂(含5%绵羊血)培养基上培养。随后鉴定细菌菌落,并通过BD Phoenix(™)中型微生物鉴定和药敏试验分析仪分析其抗生素抗性特征。结果:研究结果表明,从MICU内采集的生物气溶胶样品中细菌和真菌的主要浓度低于3.3微米的截断尺寸,它们极有可能进入人体肺部肺泡区域,从而引起机会性感染。季节和每小时的换气率与生物气溶胶浓度无统计学关系(P> 0.05);然而,患者访视的因素和温度,采样期间的相对湿度与生物气溶胶浓度在统计学上吻合(P <0.001)。就细菌菌株的鉴定而言,革兰氏阳性细菌主要是与II型危险组(RG)分离的。至于MICU的抗生素耐药菌分析,确定了63.5%的菌株对指定为第一类(17种)和第二类(18种)抗生素的国家健康保险局(NHIA)产生耐药性。这种现象很可能会影响在医院环境中工作的医务人员。结论:因此,应仔细评估MICU通风设计的建议,以控制医院感染以及正确使用个人防护设备的有效性,以减少生物气溶胶的机会感染和有害的暴露影响。

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