普胸外科患者携带MRSA与MDRAB的分子流行病学研究

目的研究该院普胸外科患者携带耐甲氧西林金黄色葡萄球菌(MRSA)与多重耐药鲍曼不动杆菌(MDRAB)的分子流行病学特征,研究其传播途径及发生机理,为降低其发生率提供理论基础。方法收集该院普胸外科32例同时携带MRSA与MDRAB患者的菌株,进行抗生素药物敏感实验,根据抗菌谱进行表型分型,并采用全基因组稀有位点限制性内切酶酶切脉冲场凝胶电泳(PFGE)分析MRSA与MDRAB的基因分型。聚类分析菌株之间的同源性。结果表型分析结果显示32株MRSA和MDRAB可分为4型,其中,MRSA中21株属于Ⅰ型,9株属于Ⅱ型,1株Ⅲ型,一株Ⅳ型。而MDRAB的分型分析结果显示:23株属于Ⅰ型,6株属于Ⅱ型,2株属于Ⅲ型,1株属于Ⅳ型,32株菌株共有24株的表型相同,PFGE基因分型法显示可将两种菌型分为6型,其中,32株MRSA中,18株属于A型的不同亚型,而14株属于A1型。32株MDRAB中,23株属于A型,A1型17株。32株菌株的PFGE分型结果显示有25株的分型结果相同。结论该院普胸外科携带MRSA与MDRAB患者的表型分型及PGGE分型结果类似,并且A1亚型的分布较多。提示有医院感染的可能。

Molecular epidemiology study of MRSA and MDRAB in general thoracic surgery patients

Objective To study The molecular epidemiology of methicillin-resistant Staphylococcus aureus(MRSA)and multidrug-resistant Acinetobacter baumannii(MSRAB)in general thoracic surgery patient in our hospital,discuss the mechanism of its transmission and provide a theoretical basis to reduce the incidence of it.Methods Collect 32cases of patients carrying MRSA and MDRAB in our hospital general thoracic surgery,with antibiotic drug sensitivity test,according to the antibacterial spectrum phenotyping,and the whole-genome restriction enzyme sites of digestion of pulsed-field gel electrophoresis(PFGE)analysis of MRSA and MDRAB genotyping.Cluster analysis of homology between the strains.Results Phenotypic analysis showed that 32MRSA and MDRAB can be divided into four types,which,MRSA in 21belongs to typeⅠ,9were typeⅡ,1were typeⅢ,1were typeⅣ.The MDRAB typing analysis showed that:23were typeⅠ,6belong to typeⅡ,2were typeⅢ,and 1were TypeⅣ,a total of 24strains were of the same phenotype,PFGE genotyping assay showed type the two types of bacteria can be divided into six types,of which 32strains of MRSA,18belong to different subtypes of type A,while 14belong to type A1.In 32MDRAB,23belong to Type A,17 belong to type A1.The PFGE typing results showed that 25of 32strains were of the same typing.Conclusion The hospital general thoracic surgery patients carrying MRSA and MDRAB phenotyping and genotyping results PGGE similar to the distribution of subtypes A1and more.Suggesting the possibility of hospital infection.