新型甲型流感继发鲍曼不动杆菌感染的同源性分析

Homology analysis of acinetobacter baumannii secondary from novel infections(H1N1) influenza

目的探讨新型甲型H1N1流感继发鲍曼不动杆菌感染的同源性及临床特点。方法对5株来自感染新型甲型H1N1流感不同患者的鲍曼不动杆菌进行脉冲场凝胶电泳同源性分析,确定菌株亲缘关系,分析5株菌耐药性资料。收集病例的临床资料,总结临床特点。结果 5株菌中的4株菌特征性指纹图谱带型一致为同源菌株;4株同源菌株为泛耐药株,仅对米诺环素中介耐药;另一株对亚胺培南及美洛培南敏感,头孢哌酮/舒巴坦与米诺环素中介耐药;继发鲍曼不动杆菌感染后,4例患者病情加重,出现感染性休克,2例患者死亡。结论新型甲型H1N1流感患者继发鲍曼不动杆菌感染后病情加重,为患者死亡原因之一。重症监护病房易出现鲍曼不动杆菌的克隆传播,医疗护理中彻底消毒及避免交叉感染至关重要。

[Objeetive] To explore homology of novel influenza A （H1N1） secondary acinetobacter baumannii infections. [ Methods ] A total of 5 aeinetobacter baumannii strains were analyzed by pulsed-field gel eleetrophoresis （PFGE） for homology to determine the strain relationships. The antibiotic resistance of the 5 strains and clinical data were analyzed. [ Results ] The 4 strains were found homologous by comparison of fingerprints, and they were pan- drug resistant, only intermediary drugresistant to minocyeline. The last strain was susceptible to imipenem and meropenem, intermediary drugresistant to minocycline and cefoperazone/sulbactam. After a secondary infection of acinetobacter baumannii, 4 patients were sicker, septic shock, 2 patients died. [ Conclusions ] The patients with nov- el influenza A （H1N1） virus were aggravated by acinetobacter baumannii. It was one of the causes of death for pa- tients. Clone transmission of acinetobacter baumannii is apt to appear in ICU. It is of vital importance to avoid iatro- genic cross-transmission and have thorough disinfection in medical treatment and nursing care.