院内多重耐药鲍曼不动杆菌分子流行病学特征研究

Study on molecular epidemiological characteristics of multidrug resistant Acinetobacter baumannii in one hospital

目的探讨某三级医院4年间多重耐药鲍曼不动杆菌(MDRAB)的分子流行病学特征。方法对2013—2016年4年间某院临床筛选出的51株MDRAB用PCR法检测碳青霉烯酶基因,多位点序列分型(MLST)鉴定菌株之间的亲缘关系。结果51株MDRAB100%都携带blaOXA-51型碳青霉烯酶基因,94.12%携带blaOXA-23型碳青霉烯酶基因。MLST分析发现有3种已报道的STs,依次为ST191(52.94%)、ST208(31.37%)和ST136(15.69%),它们都属于克隆复合体CC92。其中4年间ST208在医院内持续性的播散,ST191和ST136在不同时间段间断性的播散。结论该院各时间段分离的MDRAB都发生过相同ST克隆株的暴发流行,警示医院应加强预防院内感染暴发。

Objective To investigate the molecular epidemiological characteristics of multidrug-resistant Acinetobacter baumannii (MDRAB) in a tertiary hospital over a four-year period. Methods Fifty-one MDRAB strains isolated from 2013 to 2016 were collected. Carbapenemase genes were analyzed by PCR, and the genetic relationship between isolates was identified by multilocus sequence typing (MLST). Results Carbapenemase gene MDRA blaBOXA-51 was detected in all 51 isolates, and gene blaOXA-23 demonstrated positive rates of 94.12%. There were three reported STs in the MLST analysis, followed by ST191 (52.94%), ST208 (31.37%), and ST136 (15.69%), all of which belonged to clone complex CC92. Among them, ST208 spread continuously throughout the hospital in the four years, ST191 and ST136 spread intermittently at different periods. Conclusion The outbreak of the same strain ST occurred in all the MDRABs isolated in this hospital, which warned the hospital should strengthen its prevention of nosocomial infections.