一起应用PFGE的鲍曼不动杆菌医院感染溯源调查

Applying PFGE technique to trace a nosocomial outbreak caused by Acinetobacter baumannii

目的准确识别鲍曼不动杆菌引起的医院感染暴发,确定暴发来源并采取有效控制措施。方法对一起医院感染暴发中两个科室短期内分离到的6株鲍曼不动杆菌进行药敏测定及脉冲场凝胶电泳(PFGE)分子分型。结果ICU病房3名患者痰标本分离株为泛耐药菌,对测定的19种抗生素均耐受,PFGE带型一致,提示ICU存在感染暴发;呼吸内科2名患者痰标本分离株为多重耐药菌,药敏结果相同,PFGE带型不相同;ICU病人气管插管内壁分离株的药敏结果和PFGE带型与其他菌株均不相同。结论 PFGE技术成功运用于鲍曼不动杆菌医院感染暴发识别及溯源,医院积极采取消毒隔离措施,避免了暴发扩散。

Objective To detect the nosocomial outbreak of Acinetobacter baumanni,determine the source of the outbreak and take effective control measures. Methods Six Acinetobacter baumanni isolates were collected from two departments of a hospital in a short term. Antimicrobial susceptibility test（AST） and pulsed-field gel electrophoresis（PFGE） typing were carried on the isolates. Results The three isolates from ICU patients were tested pan-drug resistant and their PFGE patterns were indistinguishable,which indicated a nosocomial outbreak happened in ICU. The two strains from respiratory medicine department shared the same multi-drug resistance but different PFGE patterns,while the one from the inner wall of the trachea intubation has distinguish AST results and PFGE pattern from the others. Conclusion In this case,PFGE method was successfully applied in detection and tracing of the nosocomial outbreak of Acinetobacter baumanni,which help to taking effective disinfection and quarantine measures,and preventing the spread of the outbreak.