摘要
目的从基因水平了解多重耐药鲍曼不动杆菌(MDR-AB)中仅黏菌素敏感鲍曼不动杆菌(COS-AB)的流行情况,为控制其流行暴发提供实验数据。方法收集并分析上海瑞金医院2004年6月至2005年5月136例COS-AB临床感染患者的临床资料,同时收集2004年5月至2004年12月临床分离的鲍曼不动杆菌66株,其中COS-AB33株,非黏菌素敏感鲍曼不动杆菌(non-COS-AB)33株,采用随机引物PCR(RAPD)和脉冲场凝胶电泳(PFGE)等分子流行病学方法和统计学方法分析其流行情况。结果证实2004年6月至2005年5月出现COS-AB的暴发流行,经RAPD(引物ERIC2、272)分型均为一个型别,而PFGE分型为两个型别,其中烧伤科COS-AB为PFGE B型,为单一克隆的科室内流行;而烧伤科以外的其他科室为A型,为科室间流行,且主要集中于外科系统。结论COS-AB交叉感染严重,应严格消毒隔离措施,加强对COS-AB在环境及患者中流行情况的严密监测。用PFGE对鲍曼不动杆菌进行分型更为精确。
Objective To genetically analyze the epidemiology of the colistin-only-sensitive （COS） Acinetobacter baumannii （COS-AB） so as to provide experimental data for controlling COS-AB infection. Methods The drug resistance to 14 antibiotics of 136 COS-AB isolates collected in Ruijin Hospital from June 2004 to May 2005 were analyzed. 66 A. baumannii isolates were collected from May to December 2004, of which 33 strains were COS-AB and the other 33 non-COS-AB. Random amplified polymorphic DNA （RAPD） and pulsed-field gel electrophotesis （PFGE） were applied to analyze the homology of these strains. Results RAPD analysis （with the primers ERIC2 and 272） showed all COS-AB strains as identical, while PFGE analysis showed that these COS-AB were of two closely related genotypes distinctly different from that of the non-COS-AB. The COS-AB strains obtained from the Burns Ward were PFGE B type causing interward outbreak of single done. And the COS-AB strains obtained from another wards were PFGE BA type causing inter-departmental outbreak, mainly among the departments of surgical system. Conclusion The cross-infection of COS-AB is severe. Strict disinfection and sterilization should be implemented. The epidemiology of COS-AB in environment and patients should be closely monitored. PFGE analysis is a more accurate method in typing A. baumannii.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第9期592-595,共4页
National Medical Journal of China
关键词
不动杆菌属
流行病学
分子
交叉感染
Acinetobacter
Epidemiology, molecular
Cross-infection
