鲍曼不动杆菌引起的神经外科患者医院内脑膜炎暴发。

Outbreak of nosocomial meningitis caused by Acinetobacter baumannii in neurosurgical patients.

作者信息

Wroblewska M M, Dijkshoorn L, Marchel H, van den Barselaar M, Swoboda-Kopec E, van den Broek P J, Luczak M

机构信息

Department of Medical Microbiology, Medical University in Warsaw, Poland.

出版信息

J Hosp Infect. 2004 Aug;57(4):300-7. doi: 10.1016/j.jhin.2004.04.009.

DOI:10.1016/j.jhin.2004.04.009

PMID:15262390

Abstract

An outbreak of nosocomial meningitis caused by Acinetobacter baumannii, which developed postoperatively in seven neurosurgical patients is described. The clinical isolates of A. baumannii were typed by biochemical profiles and antibiogram patterns, and by random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) and amplified fragment length polymorphism (AFLP) fingerprinting. The implicated strain was multi-drug resistant, however, susceptibility to imipenem and netilmicin was detected. An extensive search for the environmental source of the epidemic strain was carried out. Two of several isolates from hospital environment, corresponded to the A. baumannii outbreak strain, one being cultured from the suctioning equipment used in the care of these patients. The introduction of multiresistant epidemic A. baumannii into a neurosurgical unit is a severe risk factor for patients undergoing neurosurgical procedures. Genotypic typing methods are important for definitive identification of these strains in patients and their environment.

摘要

本文描述了一起由鲍曼不动杆菌引起的医院内脑膜炎暴发事件，该事件发生在7名神经外科手术后的患者身上。通过生化特征、抗菌谱模式、随机扩增多态性DNA聚合酶链反应（RAPD-PCR）和扩增片段长度多态性（AFLP）指纹图谱对鲍曼不动杆菌的临床分离株进行了分型。所涉及的菌株具有多重耐药性，但对亚胺培南和奈替米星敏感。对该流行菌株的环境来源进行了广泛搜索。从医院环境中分离出的几株菌株中有两株与鲍曼不动杆菌暴发菌株一致，其中一株是从这些患者护理过程中使用的吸引设备上培养出来的。多重耐药的流行鲍曼不动杆菌引入神经外科病房是接受神经外科手术患者的一个严重危险因素。基因分型方法对于在患者及其环境中明确鉴定这些菌株很重要。