摘要
目的调查福建省某综合性医院各临床科室多重耐药鲍曼不动杆菌(MDR-AB)的流行情况以及耐药性与基因型别之间的关联,为临床预防及治疗提供指导。方法随机收集MDR-AB 286株,采用K-B法进行药敏试验,脉冲场凝胶电泳(PFGE)进行基因分型并对结果进行聚类分析。结果 286株MDR-AB按90%相似度可分为43种基因群,其中G23、G25为优势基因群,且2009年-2012年中均有检出,流行科室以外科片区为主,综合ICU为高发科室;结合药敏结果,各基因群除头孢哌酮/舒巴坦和米诺环素的耐药率低于40%外,其余耐药率均大于65%,且G23群的耐药比例最高,对碳青霉烯类的耐药率与G25群相比较,分布差异有统计学意义。结论控制MDR-AB菌株的流行应加强对优势克隆群的监测,合理使用抗菌药物,加强高发及流行科室的消毒灭菌工作及人员管理。
Objective To investigate the epidemic situation of multidrug - resistant Acinetobacter baumannii （ MDR - AB ） in some general hospital of Fujian province, and the association between drug resistance and genotype was also analyzed to provide guidance for clinical prevention and treatment of the infection with multidrug- resistant Acinetobacter baumannii（ MDR- AB）. Methods Two hundred and eighty - six MDR - AB strains were randomly collected to conduct the susceptibility test with Kirby - Bauer agar diffusion method. While the genotyping was performed with pulsed - field gel electrophoresis （PFGE） and the resuhs were analyzed by the cluster analysis. Results Forty - three gene groups were detected according to 90% similarity in 286 MDR - AB strains. G23 and G25 were the dominant groups and all were detected from 2009 to 2012, which were mainly prevalent in the surgical departments, especially the general Intensive Care Unit （ICU）. The drug - resistant rate of MDR - AB was higher than 65%, except Cefoperazone/sulbactam and minocycline （ 〈 40% ）. The drug- resistant rate of G23 group was highest. The statistical analysis was obviously significant about the Carbapenems - resistant rate between G23 and G25. Conclusion The measures should be taken to control the prevalence of drug - resistant strains, including monitoring the dominant clonal groups, rational use of antibiotics, strengthening the disinfection, sterilization and management of the people in the hospital.
出处
《中国卫生检验杂志》
北大核心
2013年第15期3137-3140,共4页
Chinese Journal of Health Laboratory Technology
基金
福建省卫生厅青年基金资助课题(2009-1-20)
