烧伤病房铜绿假单胞菌多重耐药流行病学调查

Epidemiology of Drug Resistance Genotypes of Pseudomonas aeruginosa in Burn Ward

目的了解烧伤病房铜绿假单胞菌环境寄生及烧伤患者多重耐药表型、产酶情况,铜绿假单胞菌医院感染的流行病学。方法全自动细菌鉴定和药敏分析系统(VITEK-32);改良三维法对β-内酰胺酶进行分析;金属酶试验用Etest条;随机扩增多态性DNA基因扩增(RAPD)方法对患者分离株和环境分离株分型,从检出时间、地点或部位进行动态分析。结果4 246份样本共检出铜绿假单胞菌352株,分离率为8.3%;患者与环境及医护人员检出的铜绿假单胞菌未见有关联;铜绿假单胞菌可产生多种β-内酰胺酶。结论铜绿假单胞菌广泛存在于烧伤病房的患者及环境中;铜绿假单胞菌医院感染外源性因素不主要,患者多是自身感染。

OBJECTIVE To evaluate the epidemiology of Pseudomonas aeruginosa （PAE） nosocomial infection and analyze β-1actamase in multi-resistant strains and the enzymes produced by PAE, and to detect the correlation of the PAE in patients without nosocomial infection and from the hospital environment. METHODS The strains were identified by VITEK32, dynamically the strains of multi-resistant PAE were selected with K-B susceptibility method, then the three-dimensional method, and metal-β-lactamase determined by Etest. The isolated PAE strains from the patients or the environment were analyzed according to the detected time, environmental site as which part of the patient by randomly amplified polymorphism DNA（RAPD）. RESULTS Totally 352 strains of PAE were isolated from 4246 specimens,the isolated rate was 8%. Study on the drug-fast pathogens and RAPD pathogens indicated that there was no obvious correlation between the PAE from inpatients and from hospital environment.CONCLUSIONS It indicates that PAE exists in the burn ward extensively and hospital environment and exogenous infection are unimportant in nosocomial infection. The most of PAE are derived from the patients themselves.