衡阳地区鲍曼不动杆菌基因分型及医院感染分布情况

Molecular Epidemiology Study on Hospital Infection and Genotype in Acinetobacter Baumann in Hengyang

目的研究鲍曼不动杆菌医院感染分子流行病学的情况,为控制医院感染提供直接、可靠的参考依据。方法对衡阳地区2011年1月～12月临床送检18 000份标本中分离出的480例鲍曼不动杆菌的药敏试验结果等进行回顾性分析,了解鲍曼不动杆菌医院感染现状;建立随机扩增多态性DNA(RAPD)基因分型方法对其中140株多重耐药鲍曼不动杆菌进行基因分型。结果 480例鲍曼不动杆菌标本主要来自ICU、呼吸内科、烧伤科等;标本分布以痰标本最高占65.0%,其次为伤口分泌物标本占20.0%,中段尿10.0%,其它类型标本占5.0%;480株鲍曼不动杆菌的多重耐药情况非常严重,对亚胺培南/美罗培南耐药率分别为36.0%和38.0%,对其它大多数抗菌药物的耐药率为80%以上;140株多重耐药鲍曼不动杆菌用RAPD分型方法分为8种类型:A～H,其中A、B、C 3型共占70.0%。结论鲍曼不动杆菌耐药性呈上升趋势,且具有多重耐药性;衡阳地区医院感染多重耐药鲍曼不动杆菌可能存在院内的克隆传播。

Objective To study the molecular epidemiology of Acinetobacter baumann in hospital infection for provi- ding direct and reliable reference of hospital infection control. Method Totally 480 strains of Acinetobacter baumann were collected and statistically analyzed. Establish random amplification polymorphism deoxyribonucleic acid （RAPD） Genotyping system to analyze the genotype of 140 strains of Multi-resistance Acinetobacter baumann. Result The most specimen were acquired in intensive care unit （ICU）, department of respiratory medicine and department of bums and so on. Acinetobacter banmann isolated from sputum specimen is 65.0% , secretion of wound is 20.0% and medistream urine is 10.0%. The resist- ant rates of Acinetobacter baumannii to meropenem and imipenem were 36.0% and 38.0% respectively ,the resistance rate to other antibacterial drugs was above 80%. 140 strains of Multi-resistance Acinetobacter banmann were divided into 8 types（ A- H） by RAPD typing. Types A, B and C was above 70%. Conclusion Multi-resistance Acinetobacter baumannii is one of the most important pathogens with multiple antibiotic resistances,and nosocomial infection may exist.