Turton J F, Kaufmann M E, Warner M, Coelho J, Dijkshoorn L, van der Reijden T, Pitt T L
Specialist and Reference Microbiology Division, Laboratory of Healthcare Associated Infection, Health Protection Agency, 61 Colindale Avenue, London NW9 5HT, UK.
J Hosp Infect. 2004 Nov;58(3):170-9. doi: 10.1016/j.jhin.2004.05.011.
A multiresistant clone of Acinetobacter baumannii was identified in 24 hospitals in the UK, predominantly in the London area, over a period of three years. Isolates were characterized by distinctive ApaI macrorestriction profiles, as resolved by pulsed-field gel electrophoresis (PFGE), which all clustered within 80% similarity using a 1% band position tolerance setting. The first isolates identified were received by the reference laboratories in April 2000, and by June 2003, a total of 375 isolates with similar PFGE profiles from 310 patients from 24 hospitals had been received. The isolates originated mainly from sputum and wound specimens, with the majority from patients in intensive care units. Amplified fragment length polymorphism analysis of a subset of isolates showed that they clustered closely, supporting the PFGE results. All the isolates tested were highly resistant to ampicillin, piperacillin, piperacillin/tazobactam, ceftazidime, cefotaxime, gentamicin and ciprofloxacin, and most isolates were carbapenem resistant. Amikacin sensitivity varied from susceptible [minimum inhibitory concentration (MIC) <or= 4 mg/L] to highly resistant (MIC >256 mg/L).
在三年时间里，英国24家医院，主要是伦敦地区，发现了一株多重耐药的鲍曼不动杆菌克隆株。通过脉冲场凝胶电泳（PFGE）分析，分离株具有独特的ApaI酶切图谱特征，在1%条带位置容差设置下，所有图谱在80%相似度内聚类。最早鉴定的分离株于2000年4月被送至参考实验室，到2003年6月，共收到来自24家医院310例患者的375株具有相似PFGE图谱的分离株。分离株主要来源于痰液和伤口标本，大多数来自重症监护病房的患者。对一部分分离株进行的扩增片段长度多态性分析表明它们紧密聚类，支持了PFGE结果。所有测试的分离株对氨苄西林、哌拉西林、哌拉西林/他唑巴坦、头孢他啶、头孢噻肟、庆大霉素和环丙沙星高度耐药，大多数分离株对碳青霉烯类耐药。阿米卡星敏感性从敏感[最低抑菌浓度（MIC）≤4mg/L]到高度耐药（MIC＞256mg/L）不等。
