多药耐药鲍氏不动杆菌基因同源性分析及流行病学调查

目的 了解重症监护病房(ICU)流行的多药耐药鲍氏不动杆菌(MDR-AB)耐药谱特征及其同源性,为临床防治提供依据.方法 MDR-AB分离自2007年5月,4株系住ICU肺部感染患者的痰标本,4株系病房物体表面;按<全国检验技术操作规程>要求操作,用全自动微生物分析仪进行细菌鉴定及药敏试验;用脉冲场凝胶电泳(PFGE)对8株鲍氏不动杆菌进行基因分型,明确其是否为同一菌株的克隆.结果 4株痰标本的鲍氏不动杆菌对包括碳青酶烯类在内的多种抗菌药物耐药,经DNA分型同为A型,另4株物体表面的鲍氏不动杆菌经DNA分型亦同为A型,8株有高度同源性,证实为同一克隆株.结论 鲍氏不动杆菌为多药耐药株,同一克隆株在不同感染个体间的相互传播导致了ICU内感染的流行;1号株可能是交叉感染的源头,医护人员标准预防未到位,尤其是手卫生问题是可能的传播途径.

Multidrug Resistance of Acinetobacter baumanii and Homogeneous Analysis

OBJECTIVE To understand the drug-resistant status of Acinetobacter baumanii and provide scientific basis for infection treatment. METHODS Eight multidrug-resistant A. baumannii (MDR-AB) strains isolated from nosoeomial inpatients in intensive care unit (ICU) were collected in May 2007 and tested for drug sensitivity and MIC determination as well. We typed A. baumannii isolates with pulsed-field gel electrophoresis (PFGE) to determine whether they derived from the same done. RESULTS Four isolates from nosocomial inpatients were resistant to multiple antibiotics ineluding carbapenem. The PFGE types identified from eight isolates were same.All A. baumannii isolates are closely related. CONCLUSIONS The prevalence of nosocomial infection is due to transmission of the same strains among the patients in ICU. This finding highly suggests that isolate 1 was the source of this nosocomial infection and the problem of hand hygiene maybe the main transmission route.