铜绿假单胞菌医院感染现状及分子流行病学研究

目的总结本地区2010年1月-2011年12月共6400份临床细菌标本的培养及药敏结果,了解铜绿假单胞菌医院感染现状;建立随机扩增多态性DNA(RAPD)基因分型方法检测铜绿假单胞菌,调查铜绿假单胞菌医院感染流行病学的情况,为控制院内感染提供直接可靠的参考依据。方法对2010年至2011分离的240株铜绿假单胞菌进行统计分析及其临床分布;采用PAPD基因分型方法进行分析。结果 240株标本主要来自ICU,呼吸内科,普外科等;铜绿假单胞菌感染标本分布依次为:痰标本占72.5%,伤口分泌物标本占15.0%、中段尿占10.0%,其它类型标本占2.5%;240株铜绿假单胞菌的多重耐药情况非常严重,对亚胺培南/美罗培南耐药率分别为32.0%和35.0%,对其它大多数抗菌药物的耐药率为70%以上;240株PA用RAPD分型共分为7种类型:A-G。结论分离的铜绿假单胞菌多具有多重耐药性;本地区铜绿假单胞菌分为7个基因型,其中主要以A、B 2型为主,表明本地区医院感染铜绿假单胞菌可能存在院内的克隆传播。

Molecular epidemiology study on hospital infection and genotype in Pseudomonas aeruginosa

Objective To investigate the information which regard to epidemiology of Pseudomonas aeruginosa and establish random amplification polymorphism deoxyribonucleic acid（RAPD） genotyping system to detect the nosocomial infections of Pseudomonas aeruginosa in hospital infection for providing direct and reliable reference of hospital infection control.Methods 240 strains of Pseudomonas aeruginosa in 2010-2011 isolated statistical analysis of the clinical distribution.RAPD genotyping method was used to analyze its genotype.Results The most specimen were acquired in intensive care unit（ICU）;department of respiratory medicine and department of burns,and so on.Pseudomonas aeruginosa isolated from sputum specimen is 72.5%,secretion of wound is 15.0% and medistream urine is 10.0%.Other types of specimens is 2.5%.The resistant rates of Pseudomonas aeruginosa to meropenem and imipenem were 32.0% and 35.0% respectively,the resistance rate to other antibacterial drugs was above 70%.240 strains Pseudomonas aeruginosa were divided into 7 types（A-G）.Conclusion Pseudomonas aeruginosa is one of the most important pathogens with multiple antibiotic resistances,and maybe exist nosocomial infection.