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耐多药鲍曼不动杆菌仅对黏菌素敏感菌株的分子流行病学研究

[Molecular epidemiological study of colistin-only-sensitive strains of multi-drug resistant Acinetobacter baumannii].

作者信息

Yang Li, Han Li-zhong, Sun Jing-yong, Yu Yun-song, Ni Yu-xing

机构信息

Nosocomial Infection Control Office, Medical School of Shanghai Jiaotong University, Ruijin Hospital, Shanghai 200025, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Mar 7;86(9):592-5.

Abstract

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 electrophoresis (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 inter-ward outbreak of single clone. 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.

摘要

目的

对仅对黏菌素敏感的鲍曼不动杆菌(COS-AB)进行基因流行病学分析,为控制COS-AB感染提供实验依据。

方法

分析2004年6月至2005年5月在瑞金医院收集的136株COS-AB对14种抗生素的耐药情况。2004年5月至12月收集66株鲍曼不动杆菌,其中33株为COS-AB,另33株为非COS-AB。采用随机扩增多态性DNA(RAPD)和脉冲场凝胶电泳(PFGE)分析这些菌株的同源性。

结果

RAPD分析(引物为ERIC2和272)显示所有COS-AB菌株相同,而PFGE分析表明这些COS-AB有两种密切相关的基因型,与非COS-AB明显不同。烧伤病房分离的COS-AB菌株为PFGE B型,引起单克隆病房内暴发。其他病房分离的COS-AB菌株为PFGE BA型,引起跨部门暴发,主要发生在外科系统各科室。

结论

COS-AB交叉感染严重。应严格执行消毒灭菌措施。应密切监测环境和患者中COS-AB流行情况。PFGE分析是鲍曼不动杆菌分型的更准确方法。

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