小动物手术湿实验室中戴手套的手被多重耐药细菌污染及其对手术部位感染发生的潜在影响

Muhammad, Firman Abdurrahman, Awasum
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摘要

本研究旨在评估本科生湿实验室手术过程中不同阶段的无菌水平。皮肤和/或伤口拭子从不同的湿实验室组、疗程和阶段收集。使用标准微生物学程序对拭子进行细菌分离处理。共分离到葡萄球菌(38株)、链球菌(1株)、棒状杆菌(4株)、埃希氏菌(7株)、变形杆菌(8株)、克雷伯氏菌(2株)、沙雷氏菌(1株)、不动杆菌(1株)等8属62株。最常见的分离菌种为马状葡萄球菌(31株)和变形杆菌(7株),分别在外科医生及其助手未戴手套和戴手套的手、患者手术部位和手术部位感染的拭子中检出。所有分离株(革兰氏阳性和阴性)均对至少一种抗生素耐药,其中对β-内酰胺类抗生素耐药最多:氨苄西林(89.3%和100%)和阿莫西林(75%和100%)。细菌对强力霉素和亚胺培南的敏感性分别为75%和87.5%。大多数菌株(83.3%,n=30)为多药耐药,呈现24种不同的多药耐药模式之一。在通常无菌的手术过程中检测到这些细菌表明无菌的破裂。同样,多药耐药细菌传播到手术伤口的危险可能导致伤口感染、裂开、愈合延迟和术后处理费用增加。建议遵守严格的术前和术中无菌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contamination of Gloved Hands by Multidrug Resistant Bacteria ‎During Small Animal Surgery Wet-labs and its Potential Implication for ‎Occurrence of Surgical Site Infections
This study was carried out to evaluate the level of asepsis at various stages of the surgical procedures during the undergraduate students’ wet-lab sessions. Skin and/or wound swabs were collected from different wet lab groups, sessions and stages. The swabs were processed for bacteriological isolation using standard microbiological procedures. A total of 62 isolates of bacteria belonging to 8 genera: Staphylococcus (n=38), Streptococcus (n=1), Corynebacterium n=4), Escherichia (n=7), Proteus (n=8), Klebsiella (n=2), Serratia (n=1) and Acinetobacter (1), were isolated. The most commonly isolated species of bacteria were Staphylococcus equorum (n=31) and Proteus spp. (n=7), which were detected in swabs from ungloved and gloved hands of surgeon and his assistant, patient’s surgical sites and surgical site infections. All the isolates (Gram-positive and negative) were resistant to at least one antibiotic with resistance to the β-lactam antibiotics: ampicillin (89.3% and 100% and amoxicillin (75% and 100%) most observed. The bacteria were more susceptible to doxycycline (75%) and imipenem (87.5%) respectively. Majority of the isolates (83.3%, n=30) were multidrug resistant, presenting in one of 24 different multidrug resistance patterns. The detection of these bacteria from the normally aseptic surgical procedure indicates a break in asepsis. Similarly, the danger of spreading multidrug resistant bacteria to the surgical wounds may result in wound infection, dehiscence, delayed healing and increased cost of post-surgical management. It is recommended that adherence to stringent pre-surgical and intra-surgical asepsis should be observed.
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