某院院内耐碳青霉烯鲍曼不动杆菌分子流行病学研究

Molecular epidemiology of carbapenem-resistant Acinetobacter baumannii isolated from a hospital

目的研究本院某段时间分离的耐碳青霉烯鲍曼不动杆菌(CRAB)的分子流行病学特征,为医院感染的防控提供依据。方法对2015年10月至2016年2月本院临床分离的55株CRAB,采用多位点序列分型(MLST)分析菌株之间的克隆关系。采用PCR法筛选碳青霉烯酶基因和消毒剂基因qacE△1。结果 55株CRAB共检出6种已报道的STs,依次为ST208(38.2%)、ST369(25.5%)、ST195(20%)、ST451(10.9%)、ST195(3.6%)和ST381(1.8%)。碳青霉烯酶基因OXA-51和OXA-23均为阳性,96.4%(53/55)菌株携带qacE△1基因。90%以上样本分离自本院各重症监护病房患者的痰液。结论本院该时间段分离的CRAB发生过克隆株流行,产OXA-23 ST208、ST369和ST195型CRAB为本院主要的流行克隆株。

Objective To investigate the molecular epidemiological characteristics of carbapenem-resistant Acinetobacter baumannii （CRAB） isolated from our hospital at a certain time, and to provide the basis for the prevention and control of nosocomial infections. Methods Total of 55 stains of CRAB were isolated from the hospital from October 2015 to February 2016. Cloning relationship were conducted by multi-site sequence typing （MLST）. The screening of carbapenemase gene and disinfectant gene （qacEΔ1） were detected by PCR. Results Six kinds of STs were detected by MLST, which were ST208 （38.2%）, ST369 （25.5%）, ST195 （20%）, ST451 （10.9%）, ST195 （3.6%） and ST381 （1.8%）. Carbapenemase genes, such as OXA-51 and OXA-23 were both positive, and 96.4% （53/55） of the stains carried qacEΔ1 gene. More than 90% of the specimens were isolated from sputum separated from the patients in Intensive Care Unit. Conclusions There was a prevalence caused by CRAB stains of clones during this period. ST208, ST369 and ST195 CRAB carrying OXA-23 gene were the main clones in our hospital.