重症监护室患者与环境分离的多重耐药不动杆菌属细菌同源性研究

目的 了解重症监护室（ICU）患者与环境分离的多重耐药不动杆菌属细菌的同源性。方法收集ICU患者标本分离的多重耐药不动杆菌属细菌，同时对ICU环境及医务人员手部采样，分离不动杆菌属细菌；进行药敏试验；采用质粒指纹图谱及肠杆菌科基因组内重复序列聚合酶链反应（ERIC-PCR）对患者与环境菌株进行基因同源性分析。结果17株分离自ICU患者的多重耐药不动杆菌属细菌中，15株为鲍曼不动杆菌，2株为乙酸钙不动杆菌；分离自痰标本者15株，另2株分别分离自创面分泌物及头皮组织。ICU环境和医务人员手分离多重耐药不动杆菌属细菌19株，其中鲍曼不动杆菌12株，乙酸钙不动杆菌7株；主要分离自ICU患者床头柜表面、呼吸机螺纹管口、氧气湿化瓶、水龙头表面、计算机键盘以及医务人员的手等。分离自患者的不动杆菌属细菌对亚胺培南、氨苄西林／舒巴坦具有一定敏感性，对几乎所有头孢菌素、氨曲南、氨基糖苷类、喹诺酮类药物均高度耐药。经质粒指纹图谱及ERIDPCR基因检测，患者感染株和环境菌株存在同源性。结论ICU存在多重耐药不动杆菌属细菌的交叉感染与污染。须加强医务人员手部卫生观念及病区环境的清洁与消毒，控制耐药菌株的流行。

Study on homology of multidrug-resistant Acinetobacter isolated from patients and environment in intensive care unit

Objective To study the homology of multidrug-resistant Acinetobacter isolated from hospitalized patients and hospital environmental samples in intensive care unit(ICU).Methods Acinetobacter strains isolated from patients,hospital environment and hands of health care workers(HCWs) were collected,antimicrobial susceptibility tests were performed,analysis on homology among strains from patients and environment were made with plasmid profile,restriction edonuclease profile and enterobacterial repetitive interge...