某院ICU患者及环境分离鲍曼不动杆菌同源性分析

Homology analysis on Acinetobacter baumannii isolated from patients and environment in intensive care unit of a hospital

目的调查某院ICU患者及环境分离鲍曼不动杆菌的同源性。方法对江苏省该院ICU采集的180份患者和环境标本进行鲍曼不动杆菌分离、药敏分析以及脉冲场凝胶电泳(PFGE)分型。结果从180份样本中分离出41株鲍曼不动杆菌,其中临床菌株9株,环境菌株32株。药敏结果显示除对左氧氟沙星耐药率较低外(34.1%),对其他抗菌药物的耐药率均高于70%。41株鲍曼不动杆菌PFGE基因分型分成19型,其中I、M、N、O、P5个型别每型包含2株及以上,其余均为1株一型别;P型16株,其中有5株来自于医院感染患者,其余株来自于患者的呼吸机、治疗车以及周围环境,同时该型AB的检出时间跨度长达141 d。结论该院ICU患者及环境分离鲍曼不动杆菌具有同源性,存在医院内传播及医院感染的流行。应加强消毒措施实施的监管,尽量避免医院感染的发生及流行。

Objective To investigate the homology of Acinetobacter baumannii (A. baumannii) isolated from patients and environment in intensive care unit(ICU) of a hospital. Methods 180 sepcimens from patients and environment in ICU of a hospital in Jiangsu Province were performed A. baumannii isolation, antimicrobial susceptibility analysis and pulsed-field gel electrophoresis (PFGE) typing. Results 180 specimens were isolated 41 strains of A. baumannii , including 9 clinical strains and 32 environmental strains. Antimicrobial susceptibility testing result showed that resistance rates of A. baumannii to other antimicrobial agents were all higher than 70%, except for levofloxacin (34.1%). 41 strains of A. baumannii were classified into 19 PFGE genotypes, there were at least 2 strains in each of the five types(type I, M, N, O, and P), the others were all one type;there were 16 strains of type P, 5 of which were from patients with HAI, and the rest were from patients’ ventilators, treatment vehicles and the surrounding, the detection time span of this type of A. baumannii was 141days. Conclusion A. baumannii isolated from patients and environment in ICU of this hospital has homology, and there is transmission in hospital and epidemic of HAI. Supervision of disinfection measures should be strengthened in order to avoid the occurrence and epidemic of HAI as far as possible.