一起脊柱外科鼠伤寒沙门菌疑似医院感染暴发的调查与处置

Investigation and Disposal of a Suspected Hospital Infection Outbreak of Salmonella typhimurium in a Spinal Surgery Department

摘要: 目的：调查一起脊柱外科鼠伤寒沙门菌疑似医院感染暴发事件，分析危险因素并总结防控措施，为同类事件处置提供参考。方法：对2025年9月17日~9月24日某院脊柱外科聚集性感染性腹泻病例开展流行病学调查、环境卫生学监测及病原学检测，采取隔离、消毒、手卫生强化等综合干预措施并评估效果。结果：短期内共发生4例感染性腹泻病例，确诊鼠伤寒沙门菌医院感染2例；环境采样未检出目标菌，但高频接触物表、手卫生、卫生间消毒存在明显薄弱环节。实施综合防控后无新增病例，暴发得到有效控制，于10月未再出现新发鼠伤寒沙门菌感染病例。结论：早期识别、快速处置是控制医院感染暴发的关键。此次鼠伤寒沙门菌感染事件可能与手卫生依从性差、卫生间消杀不彻底存在污染有关。因此，在严格落实常规防控措施基础上，强化手卫生管理和环境消杀对预防和控制医院感染及暴发也至关重要。

Abstract: Objective: Investigation of a suspected nosocomial Salmonella typhimurium outbreak in a spinal surgery department following rodent bites, analysis of risk factors, and summary of preventive measures to provide reference for similar incident management. Methods: An epidemiological investigation, environmental hygiene surveillance, and pathogen detection were conducted on cases of clustered infectious diarrhea in the Department of Spinal Surgery of a hospital from September 17 to September 24, 2025. Comprehensive intervention measures including isolation, disinfection, and enhanced hand hygiene were implemented, and their efficacy was evaluated. Results: In the short term, a total of 4 cases of infectious diarrhea were reported, with 2 confirmed hospital-acquired infections caused by Salmonella typhimurium. Environmental sampling failed to detect the target pathogen, but significant weaknesses were identified in high-frequency contact surfaces, hand hygiene practices, and restroom disinfection. After implementing comprehensive prevention and control measures, no new cases were reported, and the outbreak was effectively contained. No new cases of Salmonella typhimurium infection were detected in October. Conclusions: Early identification and rapid intervention are key to controlling hospital-acquired infection outbreaks. The Salmonella typhimurium infection may be related to poor compliance with hand hygiene and incomplete disinfection of bathrooms, leading to contamination. Therefore, on the basis of strictly implementing conventional prevention and control measures, strengthening hand hygiene management and environmental disinfection is also crucial to preventing and controlling hospital infections and outbreaks.