(精选)【医学课件课件】分子流行病学研究教学课件.pptVIP

genomic typing: patient-to-patient transmission; nosocomial outbreak; little evidence of horizontal spread Using this information, we determined what intervention was likely to control an apparent outbreak (20). 结果： 基因分型：可将可能的医院感染分组： 病人之间交叉感染(high conality, 90%) 感染爆发(moderate clonality, 35%-75%) 无水平传播(20% clonality). 在此基础上，决定采取哪种控制措施 high conality, 90% likely patient-to-patient transmission moderate clonality, 35%-75% possibly nosocomial outbreak clonality, 20% unlikely little evidence of horizontal spread similarity During the last 2 years of this study, 25 possible microbial outbreaks were investigated by the typing laboratory VRE, fluoroquinolone-resistant P. aeruginosa, MRSA, E. cloacae, C. difficile. 通过基因分型，共鉴别25起微生物感染爆发 VRE 氟喹诺酮耐药的铜绿 MRSA 阴沟 难辩梭菌 Classic Spread of Nosocomial Infection VRE: 19 strains, from 16 patients, in a 2-month period; 14 strains: from one of two clones (88%) Indicating: a high probability of nosocomial spread Review: microbiology laboratory: culture requisitions---no close contact. Patients: existing direct connection between 11/14 patients (14). infection control practices: aborted the outbreak 典型的医院感染传播 VRE: 19株, 来自16个病人，2个月时间内; 其中十四株：为两个型别中的一个型别 (88%) 高度提示感染传播 检查分析: 微生物实验室: 培养过程无密切联系 患者：14人中有11人有直接联系 感染控制：中止暴发 Moderate Likelihood of Spread of Nosocomial Infections During a 1-month period, in a special-care unit invasive infections, caused by five isolates Klebsiella pneumoniae, S. epidermidis, and S. hemolyticus DNA typing indicated 40% to 60% for each of the bacterial species. patients with genetically identical organisms occupied adjacent beds. Erecting a barrier on the unit, along with educating medical staff, halted the spread of these infections (15). 较有可能为NI传播 1个月时间内，特殊病房 侵入性操作感染： 肺炎克雷伯菌 表皮葡萄球菌 溶血葡萄球菌 40%-60% clonality 分析：分离出相同型别菌株的患者病床临近 措施： 病房设立屏障 医护人员教育 结果：感染中止 Outbreaks not Caused by Patient-to-Patient Spread Suspected outbreaks consisting of four isolates of K. pneumonia and 64 strains of Serrat