重症监护病房临床与环境、手分离耐药革兰阴性杆菌的同源性研究

Homology Study of Resistant Gram-negative Bacilli Isolating from Hospitalized Patients,Hospital Environment and Hands in Intensive Care Unit

目的了解重症监护病房(ICU)临床与环境分离耐药革兰阴性杆菌的同源性。方法收集自ICU临床标本分离的耐药革兰阴性杆菌58株,同时在ICU环境及医护人员手部采样,分离革兰阴性杆菌,采用质粒指纹图谱和限制性酶切图谱及肠杆菌科细菌重复系列PCR,对临床与环境分离的同种耐药菌株进行同源性分析。结果从临床和环境分离的肺炎克雷伯菌、阴沟肠杆菌、不动杆菌属经质粒指纹图谱及ERIC-PCR基因检测均存在同源性菌株,且神经外科存在耐药阴沟肠杆菌的暴发。结论ICU中存在着多药耐药革兰阴性杆菌的交叉污染与感染流行,必须加强医护人员手卫生观念及病区环境的清洁与消毒,控制耐药菌株的流行。

OBJECTIVE To study the homology of resistant Gram-negative bacteria isolating from the hospitalized patients, hospital environment and hands of medical staffs in intensive care unit （ICU）. METHODS To collect and identify 58 clinical resistant Gram-negative bacteria isolates and environment isolates from intensive care units, the same type of Gram-negative bacilli were studied on the homology using plasmid profile, restriction endonuclease profile and enterobacter repetitive intergenic consensus PCR （ERIC-PCR）. RESULTS The homology existed between the resistant bacteria of clinical isolates and environment specimens. CONCLUSIONS We found that the multidrug-resistant Gram-negative bacteria derive from a common origin and cause an outbreak in ICU. So medical staff must emphasize the concept of hand hygiene and reinforce the measure of cleaning and sterilization, in order to control nosocomial infection.