上海市医护人员手部分离鲍氏不动杆菌株耐药性和毒力基因

Drug resistance and virulence genes of Acinetobacter baumannii isolated from the hands of medical staff in Shanghai

目的分析上海市医疗机构工作人员手分离鲍氏不动杆菌的耐药基因与毒力基因.方法选取2018-2021年上海市16所不同级别医院工作人员为研究对象,对医疗机构重点科室工作人员的手进行采样、分离、鉴定,对鲍氏不动杆菌进行药敏试验、利用BioNumerics软件对全基因组测序数据组装,对组装基因组开展多位点序列分型(MLST)、核心基因组多位点序列分型(cgMLST)、毒力基因、耐药基因、耐药性与毒力基因相关性分析.结果45株菌株除对替米卡星敏感,对其他21种抗菌药物呈现不同程度耐药,45株菌株携带多种耐药基因与毒力基因,24.44%菌株携带耐消毒剂基因,鲍氏不动杆菌的耐药性与毒力基因csuA/B、abaI、hemO、KatA密切相关,cgMLST分型显示在医院中有可能存在以手作为传播载体的鲍氏不动杆菌的克隆传播.结论本市医护人员手部分离鲍氏不动杆菌携带多种耐药基因与毒力基因的特征,实施有效措施加强医护人员手卫生依从性与执行率,为阻止耐药菌株的传播有着十分重要的意义.

OBJECTIVE To analyze the drug resistance and virulence genes of Acinetobacter baumannii isolated from the hands of medical staff in Shanghai,China.METHODS From 2018 to 2021,the staff of 16 hospitals of different levels in Shanghai were selected as the study subjects,and the hands of the staff of the key departments in medical institutions were sampled,isolated,and identified.Drug sensitivity tests were conducted on Acinetobacter baumanni,and whole genome sequencing data were assembled using BioNumerics software.The assembled genome was analyzed for multi-locus sequence typing(MLST),core genome multi-locus sequence typing(cgMLST),virulence genes,resistance genes,and correlation between resistance and virulence genes.RESULTS Forty-five strains were resistant to 21 antimicrobial drugs in various degree except for Temikacin,45 strains carried multiple resistance and virulence genes,and 24.44%of the strains carried disinfectant resistance genes,the resistance of Acinetobacter baumannii was closely related to virulence genes csu A/B,aba I,hemO and Kat A.The cgMLST typing indicated the possibility of clonal transmission of Acinetobacter baumanni in hospitals using the hands as a vector of transmission.CONCLUSION The Acinetobacter baumannii isolated from the hands of medical staff in this city carried the characteristics of multiple resistance and virulence genes,and the implementation of effective measures to strengthen the compliance and implementation rate of hand hygiene among healthcare workers was of great significance in order to stop the spread of drug-resistant strains of bacteria.