62株耐碳青霉烯类鲍曼不动杆菌的同源性分析

Homology analysis on 62 strains of carbapenem-resistant Acinetobacter baumannii

目的了解某院住院患者分离的耐碳青霉烯类鲍曼不动杆菌(CRAB)同源性,为预防CRAB医院传播提供依据。方法检测2015年8月—2016年11月该院住院患者各类临床标本分离的62株CRAB药敏结果,利用脉冲场凝胶电泳(PFGE)分析同源性及其流行特征。结果 62株CRAB主要来自痰标本(占88.71%),对头孢他啶、头孢吡肟、亚胺培南、美罗培南、环丙沙星均耐药,对左氧氟沙星的耐药率(25.81%)最低。62株CRAB分为14个不同的型别,分别为A^N型,其中B、D、E、J和M型别仅包含1株菌,其中F型别包含5个亚型,A、G、H和K型别均有3个亚型,C和I型各有2个亚型。对主要的克隆株临床资料进行分析,32株菌(占51.61%)来自重症监护病房(ICU),另有12株菌(占19.35%)分离患者曾入住ICU。结论医院内流行的鲍曼不动杆菌存在外部带入和内部传播两种形式,需加大对其感染控制力度。

Objective To understand the homology of carbapenem-resistant Acinetobacter baumannii(CRAB)isolated from hospitalized patients in a hospital,and provide evidence for the prevention of CRAB spread in hospital.Methods Antimicrobial susceptibility testing of 62 strains of CRAB isolated from all kinds of clinical specimens from hospitalized patients between August 2015 and November 2016 was performed,homology and epidemic characteristics were analyzed by pulsed-field gel electrophoresis(PFGE).Results 62 strains of CRAB were mainly from sputum specimens(88.71%),all were resistant to ceftazidime,cefepime,imipenem,meropenem,and ciprofloxacin,resistance rate to levofloxacin was the lowest(25.81%).62 strains of CRAB were divided into 14 different types(A-N),type B,D,E,J,and M only contained 1 strain respectively,type F contained 5 subtypes,type A,G,H,and K had 3 subtypes respectively,type C and I had 2 subtypes respectively.Clinical data of the main cloned strains were analyzed,32 strains(51.61%)were isolated from patients in intensive care unit(ICU),and 12 strains(19.35%)from patients who had ever stayed in ICU.Conclusion There are two forms of Acinetobacter baumannii prevailed in hospital,which are external and internal spread,infection control should be strengthened.