重症监护室多重耐药鲍曼不动杆菌院内感染暴发的调查分析

Survey on homology of multi-drug resistant Acinetobacter baumannii isolated from ICU patients and environment

目的对分离自重症监护室(ICU)患者及环境中的鲍曼不动杆菌进行同源性分析,判断ICU是否存在院内感染暴发流行。方法使用贝克曼Microscan Walkaway 40 plus鉴定及药敏分析仪对分离自ICU患者及环境中的鲍曼不动杆菌进行鉴定及抗菌药物敏感性试验,采用肠杆菌科基因组间重复序列(ERIC-PCR)对分离到的鲍曼不动杆菌进行同源性分析,结合流行病学调查结果,寻找导致院内感染暴发的原因。结果从ICU患者及环境中共分离出20株鲍曼不动杆菌,其中19株为多重耐药菌,1株为泛耐药菌。20株鲍曼不动杆菌共分为3型(A-C型),其中17株属于C型。结论本次ICU多重耐药鲍曼不动杆菌院内感染暴发流行由C型引起,含有多重耐药鲍曼不动杆菌的气溶胶可能是引起此次院内感染暴发流行的原因。

Objective To analysis the homology of Acinetobacter baumannii isolated from intensive care unit （ICU） patients and the environment, and provide evidence to control Acinetobacter baumannii nosocomial infection outbreak. Methods Acinetobacter baumannii isolated from ICU patients and environment were identified and tested drug sensitivity by using Microscan Walkaway 40 plus. The homogeneous genotype was performed by using ERIC- PCR. Combining with epidemiological findings and ERIC- PCR, the reasons leading to nosocomial infection outbreak were analyzed. Results Twenty strains of Acinetobacter baumannii were isolated from ICU patients and environment. 19 out of 20 were multi-drug resistant, and 1 was pan-drug resistant. Homology analysis showed that 20 Acinetobacter baumannii isolates were divided into 3 genotype （A-C）. 17 of them were C genotype. Conclusion The Acinetobacter baumannii nosocomial infection outbreak was caused by C genotype. The cause of nosocomial infection outbreak was the aerosol containing multi- drug resistant Acinetobacter baumannii.