厦门地区泛耐药鲍氏不动杆菌临床分布与分子流行特征的研究

Clinical distribution and molecular epidemiology of pandrug-resistant Acinetobacter baumannii in Xiamen area

目的调查厦门地区泛耐药鲍氏不动杆菌(PDRAB)的临床与分子流行特征以及耐药性,分析其流行趋势,为有效预防与控制泛耐药鲍氏不动杆菌医院感染提供依据。方法回顾性研究厦门地区分离的20例感染PDRAB患者临床资料,应用脉冲场凝胶电泳技术对PDRAB进行分子分型,分析其流行特征和耐药性。结果厦门地区分离的20株PDRAB系9种克隆株;患者PDRAB的医院感染时间多发生在入院48h后,临床治愈率仅为15.0%;PDRAB克隆株对米诺环素和多黏菌素敏感,耐药率为0,其余抗菌药物耐药水平均较高,耐药率为75.0%～100.0%。结论加强厦门地区PDRAB的目标性检测,有利于预防与控制PDRAB感染的暴发和流行。

OBJECTIVE To investigate the clinical and molecular feature and resistance of pandrug-resistant Acinetobacter baumannii（PDRAB） in Xiamen area,analyze its epidemic tendency and provide reference for prevention and control of the nosocomial infection. METHODS The clinical data of non-repetitive 20 strains of PDRAB isolated from Xiamen area were retrospectively analyzed.The molecular typing of PDRAB isolates was determined by pulsed field gel electrophoresis.The antibiotics susceptibility testing was done by K-B.Their drug-resisitance and molecular epidemiology were analyzed. RESULTS The PDRAB isolates from Xiamen area were non-homologous with 9 clones.The majority of PDRAB infecions occurred two days after admission.The situations of the patients with PDRAB infection were serious,only 15.0% were cured.The clones of PDRAB had high-level drug-resistance to most antibiotics,drug resistante rates were 75.0%-100.0%,but were susceptible to mimocycline and polymyxin. CONCLUSION Target monitoring of PDRAB in Xiamen area should be strengthened to control the nosocomial infection caused by those strains.