新疆地区鲍曼不动杆菌多重耐药菌株同源性分析

Homology analysis of the multi-drug resistant Acinetobacter baumannii strains in Xinjiang

目的了解全疆各地(州)医院多重耐药鲍曼不动杆菌克隆株分布情况,为全疆各级医院院感管理监控部门进行监控、切断流行株的来源及传播途径,防止交叉感染,提供重要的实验室依据。方法收集新疆9地(州)医院ICU多重耐药鲍曼不动杆菌72株,经VITEK 2-Compact微生物分析系统初步鉴定为鲍曼不动杆菌复合群,再参照全国临床检验操作规程鉴定确定菌株,药敏试验采用VITEK-GNS药敏卡及纸片扩散法。分型方法采用DiversiLab系统,使用Agilent 2100操作软件,生成分析报告。结果 72株碳青霉烯类耐药鲍曼不动杆菌均为多重耐药菌;该菌对多黏菌素B(1.3%)、替加环素(1.7%)耐药率较低。3型基因型为乌鲁木齐独有;4型主要分布于昌吉、和田地区,呈现特有的显著条带;2型出现在乌鲁木齐、和田地区;1型全疆流行株,各地区均有分布,相似性系数达99%。结论多重耐药鲍曼不动杆菌检出菌株在全疆不同地区、医院、病房或同一地区、医院、病房中发生克隆株扩散传播、散在传播及交叉感染。

Objective To understand the distribution of multi-drug resistant Acinetobacter baumannii clones in hospitals across Xinjiang for the purpose to improve infection control.Methods A total of 72 A.baumannii strains were collected from ICU in the hospital in 9 prefectures across Xinjiang.A.baumannii complex was preliminarily identified by VITEK 2-Compact microbial analysis system,and confirmed by national standard identification procedures.Antimicrobial susceptibility test was conducted by using VITEK-GNS susceptibility card and Kirby-Bauer method.The strains under study were typed by using the DiversiLab system and Agilent 2100 operating software to generate report.Results The 72 carbapenem-resistant A.baumannii strains were also multidrug resistant.These strains showed relatively lower resistance rate to polymyxin B(1.3%)and tigecycline(1.7%).Clone 3 was the unique genotype in Urumqi.Clone 4 was the unique genotype in Changji and Hotan with distinctive bands.Clone 2 was identified in Urumqi and Hotan.Clone 1 was the endemic strain across Xinjiang,with 99%homology among the isolates.Conclusions Multidrug resistant A.baumannii strains were isolated in different regions of Xinjiang.These resistant strains may have clonal spread in hospitals and wards,resulting cross infection.