耐替加环素鲍曼不动杆菌的同源性及临床分布

目的了解某院耐替加环素鲍曼不动杆菌的同源性及临床分布。方法选取该院2013—2014年各临床科室送检标本分离的多重耐药鲍曼不动杆菌（88株），检测其对替加环素的敏感性；应用脉冲场凝胶电泳（PFGE）分析替加环素耐药菌株的同源性，以及感染患者的临床特征和科室分布。结果88例患者在检出多重耐药鲍曼不动杆菌前未曾使用过替加环素。88株多重耐药鲍曼不动杆菌中4株（4.55%）对替加环素耐药，分别为10、31、33和87号菌株。PFGE结果显示，31、33和87号菌株同一基因型，同源性高，分布于医院3个不同的独立病区；31号菌株在综合重症监护病房（ICU）检出，33号菌株在急诊ICU检出，虽在不同科室检出，但在检出前患者有转科情况，曾同时期住胃肠外科和急诊ICU；87号菌株在神经外科ICU检出，此患者从未转科，检出时间距31、33号菌株检出晚7～8个月。10号菌株于急诊ICU检出，该患者未曾转科。结论该院多重耐药鲍曼不动杆菌中替加环素耐药菌株检出率低，检出菌株大部分具有同源性，不同病区可能存在交叉感染。

Homology and clinical distribution of tigecycline resistant Acinetobacter baumannii

ObjectiveTo study the homology and clinical distribution of tigecycline resistant Acinetobacter baumannii (A. baumannii) in a hospital. MethodsMultidrug resistant A. baumannii (MDRAB, n=88) from specimens from clinical departments of a hospital in 2013-2014 were collected and detected susceptibility to tigecycline; homology of tigecycline resistant strains were detected by pulsed field gel electrophoresis (PFGE), clinical characteristics and distribution of infected patients were analyzed. Results88 patients didn’t use tigecycline before MDRAB were isolated. Of 88 MDRAB strains, 4 (4.55%）were resistant to tigecycline, which were No. 10, 31,33, and 87 strains. PFGE results revealed that No. 31,33,and 87 strains were of the same genotype, and with high homology, which distributed in three different departments; No.31 strain was detected from general intensive care unit (ICU), No.33 strain was detected from emergency ICU, although strains were detected from different departments, patients were transferred before strains were isolated, and were admitted to departments of gastrointestinal surgery and emergency ICU during the same period; No.87 strain was detected from neurosurgical ICU and patient had never been transferred, the detection time was 7-8 months later than No. 31 and 33 strains. No.10 strain was isolated from emergency ICU, patient was not transferred.ConclusionOf MDRAB isolated in this hospital, tigecycline resistant strains are low, most strains are homologous, cross infection may be exists in different departments.