醫院電梯等環境表面 methicillin 抗藥性金黃色葡萄球菌之污染調查

Environmental Contamination of Methicillin-resistant Staphylococcus aureus (MRSA) in Public Area of Hospital

多重抗藥性細菌導致院內感染的問題已普遍存在於許多醫院當中，而醫院環境設施表面的污染被認為可能是造成感染的來源之一，但國內外大部分文獻皆僅針對病房內環境表面進行採檢。因此，為了解醫療機構內公共區域環境受致病菌污染之情形，本研究選取醫療機構環境中較多醫院工作者、病患及其家屬等人員有較多流動或接觸機會之公共區域進行環境表面採樣送驗，並特別針對 methicillin 抗藥性金黃色葡萄球菌 （methicillinresistant Staphylococcus aureus; MRSA） 進行檢測。檢驗結果顯示：兩間醫院各38及44件環境樣本當中，各有1件樣本（2.6%及2.3%） 檢測出 MRSA 菌株，分別採自電梯按鍵及電扶梯扶手上，表示醫院公共區域中確實有機會受到 MRSA 污染，甚至有機會成為院內感染的來源之一。此議題除期望相關單位在感染控制上加以重視外，顯示如何加強環境清潔及落實個人手部衛生也是相當重要的課題。（感控雜誌 2009; 19: 137-45）。

Nosocomial infections caused by multiple drug resistant (MDR)-bacteria are common at hospitals. Contamination of these pathogens from environmental surface is one of the potential reservoirs for outbreaks. Most environmental surveillance for outbreaks focused on wards, operation rooms, intensive care units, while environmental surfaces of public areas at hospitals were less discussed. In this study, we swabbed environmental surfaces of public areas at two hospitals where healthcare workers, patients and visitors may frequently touch. The sites of sampling included surfaces of elevator buttons, escalator handrails, pay phones, cash dispensers, and counters. Methicillin-resistant Staphylococcus aureus (MRSA) was used as an indicator to disclose MDR-bacterial contamination in public areas at hospitals. Totally one of 38 samples (2.6%) and one of 44 (2.3%) samples collected from two hospitals were positive for MRSA, respectively. The isolation sites of MRSA were from elevator button and escalator handrail. The results of this study indicated that surfaces in public areas at hospitals, where people may expose to this pathogen during daily activities, could be contaminated with MRSA. Vigorous hand washing and intensive environmental decontamination are two important measures to prevent transmission of MDR-bacteria at hospitals. (Infect Control J 2009; 19:137-45).