ICU重症患者多重耐药性嗜麦芽窄食单胞菌暴发感染分子流行病学研究

MOLECULAR EPIDEMIOLOGY STUDY ON STENOTROPHOMONAS MALTOPHILIA INFECTION IN PATIENTS IN ICU

[目的]研究ICU重症患者连续发生嗜麦芽窄食单胞菌感染,并追踪其感染源。[方法]收集2006年3～4月间ICU9例重症患者行纤支镜检查后痰标本中分离出的9株pma菌株,工作人员手分离的pma菌株2株,纤支镜冲洗液分离的pma菌株2株,进行抗生素型分析、PFGE全DNA指纹图技术分子分型,确定菌株的亲缘关系。[结果]9例患者感染的9株pma,有8株PFGE基因型相同,并与2株分离自ICU工作人员手的pma和2株分离自纤支镜的pma基因型一致。[结论]8例机械通气患者感染的pma来自于同一克隆,ICU内存在pma暴发感染。消毒不彻底的纤支镜和医护人员的手污染可能是引起本次暴发感染的感染源。

[Objective] To investigate a potential outbreak of Stenotrophomonas maltophilia （pma） infection occurred in patients in ICU and to track the source of infection. [ Methods] 13 pma strains were isolated from 9 patients in ICU （ 9 strains）, hands of medical staffs in ICU （2 strains） and fiberscopes used for intubations and aspiration （2 strains） from March to April in 2006. Antibiotic susceptibility data of all strains were collected. Homology of the strains was analyzed by the methods of anfibiotype and PFGE genotype. [Results] Of the 9 pma isolated from patients in ICU, eight had identical PFGE genotype. The isolates from two ICU staffs and two fiberscopes displayed the same genotype with the eight patients above. [Conclusions] 8 pma strains of patients in ICU come from the same clone. This result proves that clone transmission had occured in patients in ICU. Contaminated fiberscopes and hands of staffs may be the source of infection.