鲍曼不动杆菌医院感染的危险因素及基因分型研究

Study on risk factors and molecular typing of Acinetobacter baummanii in nosocomial infections

目的 了解鲍曼不动杆菌医院感染现状及危险因素 ,并证实院内危重病人监护病房(ICU)是否存在由鲍曼不动杆菌同源性菌株引起的感染。方法 对重庆市 4所医院内由鲍曼不动杆菌引发的院内感染 1 4 0例患者的危险因素进行 1∶1病例对照研究 ;同时将近期内某院ICU分离的鲍曼不动杆菌进行M1 3 PCR扩增分型。结果 研究表明与鲍曼不动杆菌医院感染相关的危险因素依次为病情 (OR =8.691 )、免疫抑制剂 (OR =4.85)、机械通气 (OR =3 .68)、抗生素使用种类 (OR =3 .0 1 4 )。基因分型结果显示从ICU分离的 1 1株鲍曼不动杆菌 ,其中有 5株的基因型完全相同。结论病情、免疫抑制剂、机械通气和抗生素使用种类为鲍曼不动杆菌医院感染危险因素 ;院内ICU存在多重耐药鲍曼不动杆菌的感染 。

Objective To study the risk factors of Acinetobacter baummanii in nosocomial infections, and to verify the nature of Acinetobacter baumannii strains isolated from intensive care unit (ICU). Methods A hundred and fourty patients associated with nosocomial infection of Acinetobacter baummanii from four teaching hospitals were selected and compared with controls through a case control study to identify risk factors. The strains isolated from the ICU were typed by polymerase chain reaction (PCR) with the primer M 13 following electrophoresis in agarose gel. Results The odds ratios ( OR s) were: state of the illness ( OR = 8.69 ), using immunosuppressant ( OR = 4.85 ), mechanical ventilation ( OR = 3.68 ) and treatment with 3 kinds of antibiotics ( OR = 3.014 ). Data from PCR studies indicated that these strains were sharing identical band pattern from the five strains. Conclusion Risk factors for nosocomial infection with Acinetobacter baummanii included state of an illness, immunosuppressant, mechanical ventilation, and treatment with antibiotics. A multidrug resistant stravins of Acinetobacter baumannii was identified in ICU.