ICU多重耐药鲍曼不动杆菌医院感染的同源性分析

Homology analysis on ICU multidrug-resistant Acinetobacter baumannii nosocomial infection

目的对某院重症监护室(ICU)流行的多重耐药鲍曼不动杆菌感染进行同源性分析。方法收集该ICU鲍曼不动杆菌感染流行期间住院患者标本中分离的9株以及环境中分离的24株鲍曼不动杆菌,采用基因外重复回文序列聚合酶链反应(REP-PCR)技术对其进行基因分析,建立DNA指纹图谱;同时应用K-B纸片扩散法进行药敏试验。结果 9株临床分离的鲍曼不动杆菌共分为4个基因型,其中E1和E2型分别有4株和3株,E3和E4型各1株;环境样本分离的24株中,17株属E1型。药敏结果显示,临床分离株均为多重耐药株,环境分离株中19株为多重耐药株。结论此次ICU多重耐药鲍曼不动杆菌感染的流行主要是由E1和E2基因型在患者之间的相互传播所致,同时患者所处环境也被明显污染。

Objective To investigate an outbreak of nosocomial infection（NI） with multidrug-resistant（MDR） Acinetobacter baumannii （A. baumannii） in an intensive care unit （ICU）. Methods Nine strains isolated from patients and 24 strains isolated from ICU environment during NI outbreak with MDR A. baumannii were typed by repetitive extragenic palindromic-polymerase chain reaction （rep-PCR） and antimicrobial susceptibility was tested by Kirby-Bauer method. Results Nine strains isolated from patients were divided into 4 genotypes by rep-PCR, type E1 and E2 had 4 and 3 strains respectively, both type E3 and E4 had 1 strain. 24 strains of A. baumannii were isolated from the environmental samples, 17 of which belonged to type El. Antimicrobial sensitivity test results showed that all clinical isolates and 19 environmental isolates were multidrug-resistant strains. Conclusion The MDR A. baumannii outbreak in ICU was caused by transmission of E1 and E2 genotype A. baumannii among patients, and environment was also contaminated.