投稿分類 群突發處理

主委發表種類: 壁報

投稿標題(中): 結合質譜分析儀及螢光檢測法快速了解群突發原因

投稿標題(英): Prompt Response to Outbreak in District Hospital by MALDI-TOF and Fluorescent Method

投稿摘要: Background
The multi-drug resistant organisms (MDROs) such as VRE (vancomycin-resistant enterococci) could cause prolonged hospital stays and higher in-hospital mortality rate. The prevention and control of HAIs is essential to enhance patient safety and reduce health-care facilities costs. We would share our experience about prompt response to outbreak in district hospital by MALDI-TOF (matrix-assisted laser desorption ionization-time of flight) in 2020.
Methods
We used computer-assisted management programs to evaluate the raw data of HAIs to monitor routinely the ratio of nosocomial infection. The clinical environmental investigation and active screening surveillance were triggered following the occurrence of out-of-threshold monitoring values. All specimens were inoculated into tryptic soy broth with vancomycin and CHROMID® VRE agar. Finally, the suspected pathogens were identified on the Bruker MALDI Biotyper® system.
Results
At first, 16 VREs were reported from 5 patients in May 2020. The environmental investigation revealed that VRE were isolated and detected from the ward beds and folding accompanying chairs that had been disinfected with diluted bleach. Then, the fluorescent marker based cleaning monitoring method was performed following discharge of patients. We found that 16 visual signals includes toilet seat, the switchs of air condition and light, folding accompanying chair and bedside cabinet, and so on were observed by ultraviolet lamp. The evidences suggested the inappropriate disinfected cleaning initiated the outbreak. Finally, the reinforced training of disinfection technique and terminal disinfection were conducted to avoid further potential outbreaks.
Conclusion
In summary, the continuous quality surveillance of HAIs control should be performed in the future. The contaminated environment can facilitate cross-transmission. Rapid identification of VRE by MALDI-TOF and fluorescent marker based cleaning monitoring could significantly avoid potential outbreaks to improve patient safety.

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