Movahedi Z, Pourakbari B, Mahmoudi S, Sabouni F, Ashtiani Haghi M T, Hosseinpour Sadeghi R, Mamishi S
Department of Pediatric Infectious Diseases, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Prev Med Hyg. 2013 Mar;54(1):24-8.
Pseudomonas aeruginosa is one of the important causes of hospital-acquired infections in Intensive Care Unit (ICU) and considered as a major determinant of morbidity and mortality in patients affected by cystic fibrosis (CF). The aim of this study was to investigate clonal diversity among randomly picked P. aeruginosa isolates of CF and the other hospitalized patients in ICU.
Cultivation, identification, and antimicrobial susceptibility testing of P. aeruginosa isolates were performed using standard techniques. The genetic similarity of the strains was investigated by amplification of the Enterobacterial Repetitive Intergenic Consensus-polymerase chain reaction (ERIC-PCR) sequence.
Among 49 isolates, sixteen were isolated from 11 patients affected by CF and 33 came from an epidemiological investigation of 25 P. aeruginosa infected patients of ICU. Five clusters were generated for all isolates analyzed through ERIC-PCR genotyping. Two major clusters (B and C) were discovered in P. aeruginosa isolates of ICU and CF patients during the whole period of this study. Fifteen unique antibiogram patterns obtained from all isolates and multi-resistant P. aeruginosa (MRPA) were identified in 23 isolates (47%). MRPA isolates were detected in all clusters (except A) while pan-resistant isolates were recovered only in cluster C. The high prevalence of related or identical isolates in CF and non-CF patients can be due to transmission of particular dominant clones in ICU ward. Therefore, enhanced infection-control may become necessary to prevent further spread of clonal strains.
铜绿假单胞菌是重症监护病房（ICU）医院获得性感染的重要原因之一，被认为是囊性纤维化（CF）患者发病和死亡的主要决定因素。本研究的目的是调查随机挑选的CF患者和其他ICU住院患者的铜绿假单胞菌分离株之间的克隆多样性。
使用标准技术对铜绿假单胞菌分离株进行培养、鉴定和抗菌药敏试验。通过肠杆菌重复基因间共识聚合酶链反应（ERIC-PCR）序列扩增来研究菌株的遗传相似性。
在49株分离株中，16株从11例CF患者中分离得到，33株来自对25例ICU铜绿假单胞菌感染患者的流行病学调查。通过ERIC-PCR基因分型对所有分离株进行分析，生成了5个聚类。在本研究的整个期间，在ICU和CF患者的铜绿假单胞菌分离株中发现了两个主要聚类（B和C）。从所有分离株中获得了15种独特的抗菌谱模式，在23株分离株（47%）中鉴定出多重耐药铜绿假单胞菌（MRPA）。在所有聚类（A除外）中均检测到MRPA分离株，而全耐药分离株仅在聚类C中发现。CF和非CF患者中相关或相同分离株的高流行可能是由于ICU病房中特定优势克隆的传播。因此，可能需要加强感染控制以防止克隆菌株的进一步传播。
