Chu Y W, Leung C M, Houang E T, Ng K C, Leung C B, Leung H Y, Cheng A F
Department of Microbiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, People's Republic of China.
J Clin Microbiol. 1999 Sep;37(9):2962-7. doi: 10.1128/JCM.37.9.2962-2967.1999.
We studied the carriage of Acinetobacter spp. at five superficial sites in 79 patients from two hospitals, in 133 healthy controls from the community (medical students and new nurses), and in 198 student nurses in different classes. A total of 431 isolates from 364 positive sites of 201 subjects and 124 blood culture isolates (1997 to 1998) were genospeciated by amplified ribosomal DNA restriction analysis. Genospecies 3 was the most common species. The carriage rate of student nurses (42 of 131) was significantly lower than that of new nurses from the community (25 of 38) (chi-square test, P = 0.0004; odds ratio [OR], 4.08; 95% confidence limits, 1.78 to 9.41) but not significantly different (P = 0.1) from that of patients in the same hospital (20 of 42). Genospecies from blood cultures and subjects (acute patients and student nurses) from Prince of Wales Hospital were similar to one another but different from subjects from the community or from another hospital (chi-square test, P < 0.0001). Half of the subjects who were positive at at least two sites had different genospecies. Of the 28 sites examined, 68% showed strain variation among isolates of the same genospecies by random amplified polymorphic DNA analysis. Half of the 106 subjects who had samples taken again within 6 weeks or 6 months later were positive only once. In the 17 subjects who were positive on at least two occasions, each occasion yielded different genospecies in 13 subjects. Our results indicate that skin carriage in the majority of healthy subjects is characterized by low density, variation in genospecies and strains, short-term duration, and the typicality of a given locality.
我们研究了两所医院79例患者、133名社区健康对照者(医学生和新护士)以及198名不同班级的实习护士五个体表部位不动杆菌属的携带情况。对201名受试者364个阳性部位的431株分离菌以及124株血培养分离菌(1997年至1998年)进行核糖体DNA扩增限制性分析基因分型。基因种3是最常见的种。实习护士的携带率(131人中42人)显著低于社区新护士(38人中25人)(卡方检验,P = 0.0004;优势比[OR],4.08;95%可信区间,1.78至9.41),但与同医院患者(42人中20人)无显著差异(P = 0.1)。威尔士亲王医院血培养及受试者(急性患者和实习护士)的基因种彼此相似,但与社区或另一医院的受试者不同(卡方检验,P < 0.0001)。至少两个部位呈阳性的受试者中,一半有不同的基因种。在检测的28个部位中,68%通过随机扩增多态性DNA分析显示同基因种分离菌之间存在菌株变异。106名在6周或6个月内再次采样的受试者中,一半仅一次呈阳性。在至少两次呈阳性的17名受试者中,13名受试者每次检测的基因种不同。我们的结果表明,大多数健康受试者的皮肤携带具有低密度、基因种和菌株变异、短期持续时间以及特定局部典型性的特点。