De Vegas Elsa Zuleima Salazar, Nieves Beatriz, Araque Maria, Velasco Elsa, Ruiz Joaquim, Vila Jordi
Laboratorio de Bacteriologia Dr. Roberto Gabaldon, Departamento de Microbiologia y Parasitologia, Facultad de Farmacia y Bioanalisis, Universidad de Los Andes, Merida, Venezuela.
Infect Control Hosp Epidemiol. 2006 Apr;27(4):397-403. doi: 10.1086/503177. Epub 2006 Mar 17.
To investigate a nosocomial outbreak of infection with Acinetobacter strain RUH 1139, in the unit of high neonatal risk at University Hospital of The Andes (Merida, Venezuela).
Twenty-eight Acinetobacter strains were detected by biochemical testing and further identified to the species level by examination of the gene encoding 16S ribosomal DNA, using restriction analysis and gene sequencing. The epidemiological relationship between the strains was established by means of repetitive extragenic palindromic polymerase chain reaction (REP-PCR) and pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibilities were determined by disk diffusion.
The spread of an epidemic strain of Acinetobacter RUH 1139 among 16 patients over a period of 3 months was demonstrated using antimicrobial susceptibility testing, PFGE, and REP-PCR. The epidemic strain was also isolated in 2 of the sampled parenteral nutrition solutions. All the patients involved in the infection outbreak had received parenteral solution. Moreover, strains of Acinetobacter RUH 1139 with another PFGE pattern and of A. baumannii were sporadically isolated before and during the outbreak.
This is the first description of an outbreak of infection with this genospecies of Acinetobacter in which parenteral nutrition solution was potentially the infection source.
调查委内瑞拉梅里达州安第斯大学医院高危新生儿病房中鲁氏不动杆菌菌株RUH 1139引起的医院感染暴发。
通过生化检测检测到28株不动杆菌菌株，并通过对编码16S核糖体DNA的基因进行限制性分析和基因测序，进一步鉴定到种水平。通过重复外源性回文聚合酶链反应（REP-PCR）和脉冲场凝胶电泳（PFGE）确定菌株之间的流行病学关系，并通过纸片扩散法测定抗菌药物敏感性。
使用抗菌药物敏感性测试、PFGE和REP-PCR证明了鲁氏不动杆菌流行菌株RUH 1139在3个月内传播给16例患者。在2份采样的肠外营养液中也分离出了流行菌株。所有参与感染暴发的患者均接受了肠外营养液。此外，在暴发之前和期间偶尔分离出具有另一种PFGE模式的鲁氏不动杆菌菌株和鲍曼不动杆菌菌株。
这是首次描述这种不动杆菌基因型引起的感染暴发，其中肠外营养液可能是感染源。
