目的 调查某院肿瘤病房一起由洋葱伯克霍尔德菌(BC)引起的血管导管相关血流感染(CRBSI)暴发的原因,为预防和控制医院感染提供依据.方法 采用临床资料调查和现场采样检测相结合的方法,对此次医院感染的暴发进行流行病学调查.结果 11例次BC引起的 CRBSI发生时间集中,分别为2008年2月18日(1例)、19日(1例)、20日(6例)、21日(1例)、22日(2例);均为股静脉置管患者,均从患者血液中培养出BC,均使用了同一袋肝素钠封管液.环境卫生学调查,患者所使用的液体、一次性注射器材、环境物品细菌学检测均合格,仅在1份剩余肝素钠封管液中(患者共用此封管液)培养出1株BC,其药敏结果与患者血液培养菌株一致.立即采取措施,拔除患者深静脉置管,并抗感染治疗.11例患者7 d后血培养均无细菌生长,该病区再无相同病例出现.结论 BC污染肝素钠封管液是此次CRBSI暴发的原因,经积极采取措施,感染得到有效控制.%Objective To investigate the causes of an outbreak of Burkholderia cepacia (B. cepacia) vascular catheter-related bloodstream infection(CRBSI) in an oncology department, and provide the basis for the prevention and control of health care-associated infection. Methods Epidemiological investigation was performed by combination of clinical data analysis and on-site sampling . Results The occurrence time of 11 B. cepacia CRBSf cases concentrated on February 18(1 case) , 19 (1 case) , 20 (6 cases) , 21 (1 case) , and 22 (2 cases) of 2008, respectively ; all patients were intubated in the femoral vein, isolated B. cepacia from blood cultures ,and used the same bag of heparin sodium sealing solution. Bacterial culture results of heparin sodium sealing solution , disposable syringes, and environmental samples were all qualified, only 1 tube of used heparin sodium sealing solution (all patients shared this tube) isolated B. cepacia, antimicrobial susceptibility test result was the same as B. cepacia from patients' blood culture result. Measures were taken promptly, the deep venous catheters were removed, and anti-infective therapy was adopted ,none of the patient isolated bacteria from blood cultures 7 days later, and no identical case e-merged again. Conclusion Contamination of heparin sodium sealing solution by B. cepacia is the cause of this CRBSf , through active treatment , infection is controlled.
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