Fontana Carla, Favaro Marco, Minelli Silvia, Bossa Maria Cristina, Testore Gian Piero, Leonardis Francesca, Natoli Silvia, Favalli Cartesio
Department of Experimental Medicine and Biochemical Sciences, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy.
BMC Infect Dis. 2008 Jun 8;8:79. doi: 10.1186/1471-2334-8-79.
The nosocomial infections surveillance system must be strongly effective especially in highly critic areas, such as Intensive Care Units (ICU). These areas are frequently an epidemiological epicentre for transmission of multi-resistant pathogens, like Acinetobacter baumannii. As an epidemic outbreak occurs it is very important to confirm or exclude the genetic relationship among the isolates in a short time. There are several molecular typing systems used with this aim. The Repetitive sequence-based PCR (REP-PCR) has been recognized as an effective method and it was recently adapted to an automated format known as the DiversiLab system.
In the present study we have evaluated the combination of a newly introduced software package for the control of hospital infection (VIGI@ct) with the DiversiLab system. In order to evaluate the reliability of the DiversiLab its results were also compared with those obtained using f-AFLP.
The combination of VIGI@ct and DiversiLab enabled an earlier identification of an A. baumannii epidemic cluster, through the confirmation of the genetic relationship among the isolates. This cluster regards 56 multi-drug-resistant A. baumannii isolates from several specimens collected from 13 different patients admitted to the ICU in a ten month period. The A. baumannii isolates were clonally related being their similarity included between 97 and 100%. The results of the DiversiLab were confirmed by f-AFLP analysis.
The early identification of the outbreak has led to the prompt application of operative procedures and precautions to avoid the spread of pathogen. To date, 6 months after the last A. baumannii isolate, no other related case has been identified.
医院感染监测系统必须具备强大的有效性，尤其是在重症监护病房（ICU）等高度关键的区域。这些区域常常是多重耐药病原体（如鲍曼不动杆菌）传播的流行病学中心。当疫情爆发时，在短时间内确认或排除分离株之间的遗传关系非常重要。有几种分子分型系统用于此目的。基于重复序列的聚合酶链反应（REP-PCR）已被公认为一种有效的方法，并且最近已被改编为一种称为DiversiLab系统的自动化形式。
在本研究中，我们评估了一种新引入的用于医院感染控制的软件包（VIGI@ct）与DiversiLab系统的组合。为了评估DiversiLab的可靠性，还将其结果与使用f-AFLP获得的结果进行了比较。
VIGI@ct和DiversiLab的组合通过确认分离株之间的遗传关系，能够更早地识别鲍曼不动杆菌疫情集群。该集群涉及在十个月期间从入住ICU的13名不同患者采集的多个标本中分离出的56株多重耐药鲍曼不动杆菌。鲍曼不动杆菌分离株具有克隆相关性，其相似度在97%至100%之间。DiversiLab的结果通过f-AFLP分析得到了证实。
疫情的早期识别促使迅速采取操作程序和预防措施以避免病原体传播。迄今为止，在最后一株鲍曼不动杆菌分离株出现6个月后，未发现其他相关病例。
