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目的采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)技术对医院环境表面细菌污染状况开展调查,对其应用价值进行评价。方法 2014年6月某院ICU发生鲍氏不动杆菌感染疑似暴发,采用无菌棉签进行环境和物体表面涂抹采样,现场接种麦康凯、厌氧营养琼脂平板,典型菌落采用MALDI-TOF MS技术鉴定。结果采集环境与物体表面样本121份,其中93份表面有菌生长,细菌检出率为76.9%;医护办(站)和卫生更衣区域的物体表面细菌检出率较高,分别达94.7%和93.3%,患者和诊疗室区域物体表面的细菌检出率则明显低于上述两个区域,差异有统计学意义(χ~2=8.011,P<0.05);ICU环境和物体表面共鉴定出细菌种类19科、47种、247株,鉴定出前3位的细菌分别是葡萄球菌属(1属11种100株)占40.5%、微球菌属(1属2种67株)占27.1%和假单胞菌属(1属5种20株)占8.1%。结论 MALDI-TOF MS技术可以快速、准确鉴定细菌种类,且人力与耗材成本较低,能在较短时间内为采取感染暴发控制措施提供依据。
Objective To investigate the bacterial contamination of the surface of hospital environment by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and evaluate its application value. Methods In 2014 June, an outbreak of Acinetobacter baumannii infection was observed in ICU of a hospital. Aseptic cotton swabs were used to smear the environment and the surface of the objects. MacConkey and anaerobic agar plates were inoculated on site and the typical colonies were identified by MALDI-TOF MS . Results A total of 121 samples were collected from the environment and the surface of the object, of which 93 bacteria grew on the surface and the detection rate of bacteria was 76.9%. The detection rates of bacteria on the surfaces of the health care station (station) and the health dressing area were higher, reaching 94.7% 93.3%. The detection rate of bacteria on the surface of patients and clinic area was significantly lower than that of the above two areas (χ ~ 2 = 8.011, P <0.05) Species 19 families, 47 species and 247 strains were identified. The first three bacteria were identified as Staphylococcus (1 genus and 11 genus, 40 strains), Micrococcus species (1 genus, two species and 67 strains) accounted for 27.1% The genus of genus (1 genus 5 species 20) accounted for 8.1%. Conclusion The MALDI-TOF MS technique can rapidly and accurately identify the bacterial species, lower the cost of manpower and consumables, and provide the basis for taking control measures of outbreak of infection in a relatively short period of time.