烧伤病区泛耐药鲍氏不动杆菌的临床与分子流行特征研究

Clinical and Molecular Epidemiology of Pandrug-resistant Acinetobacter baumannii at Burn Ward

目的调查烧伤病区泛耐药鲍氏不动杆菌(PDRAB)的临床与分子流行特征及耐药性,分析其流行趋势,为有效预防与控制PDRAB医院感染提供参考资料。方法回顾性研究医院烧伤病区患者及环境非重复分离的14例PDRAB临床资料,应用脉冲场凝胶电泳(PFGE)技术对PDRAB进行分子分型,E试验法检测PDRAB的最低抑菌浓度(MIC)值,分析其流行特征及耐药性。结果烧伤病区患者及环境分离的PDRAB具有同源性,系同型克隆株传播;患者PDRAB医院感染时间多发生于入科72h后,感染类型以创面感染为主(61.5%),临床治愈率较高(87.5%);PDRAB克隆株仅对米诺环素和多黏菌素B敏感,其余抗菌药物均高水平耐药。结论加强烧伤病区PDRAB的目标性监测,有利于预防与控制PDRAB感染的暴发流行。

OBJECTIVE To investigate the clinical and molecular feature and resistance of pandrug-resistant Acinetobacter baumannii（PDRAB）at burn ward,analyze its epidemic tendency and provide reference for prevention and control of hospital-acquired infection.METHODS The clinical data of non-repetitive 14 strains of PDRAB isolated from inpatients and environment at burn ward were reviewed.The molecular typing of PDRAB isolates was determined by pulsed field gel electrophoresis.The value of minimal inhibitory concentration of PDRAB clone was determined by E test.RESULTS The PDRAB isolates from inpatients and environment were homologions at burn ward.The majority of PDRAB infections were occurred three days after burn ward admission.The main type of infection was raw surface infection（61.5%）,and the recovery rate was higher（87.5%）.The clone of PDRAB was with high-level resistance to the most common antimicrobial agents tested,just sensitive to minocycline and polymyxin B.CONCLUSIONS It＇s benefit for prevention and control of PDRAB outbreak by strengthening target monitoring of PDRAB at burn ward.