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中国一家医院呼吸内科重症监护病房鲍曼不动杆菌分离株的流行病学及耐药机制

The epidemiology and resistance mechanisms of Acinetobacter baumannii isolates from the respiratory department ICU of a hospital in China.

作者信息

Dai Xiao-Tian, Sun Feng-Jun, Chen Zhen-Hong, Luo Guang-Ming, Feng Wei, Xiong Wei, Xia Pei-Yuan

机构信息

1 Department of Pulmonology, Southwest Hospital, Third Military Medical University , Chongqing, China .

出版信息

Microb Drug Resist. 2014 Dec;20(6):618-22. doi: 10.1089/mdr.2014.0005.

Abstract

Acinetobacter baumannii is an important nosocomial pathogen able to cause severe infections in an intensive care unit (ICU). However, there is a lack of analysis regarding the epidemiology and resistance of A. baumannii in respiratory department ICUs. In this study, clinical isolates were collected from the respiratory department ICU of Southwest Hospital from January 2009 to December 2010, and the social and demographic information of the patients from whom the isolates were taken was obtained from the Southwest Hospital information system. The minimal inhibitory concentration (MIC) of the isolates was determined by the agar dilution method. The carbapenemase-encoding resistance genes of these isolates were amplified using PCR. The clonal relationship of isolates was analyzed by pulsed-field gel electrophoresis (PFGE). Forty-six isolates were collected from the respiratory department ICU, and the antibiotics minocycline and quinolone had higher drug sensitivity against these isolates. The OXA-51, OXA-23, and IMP-4 genes were present at rates of 100% (46/46), 67.4% (31/46), and 41.3% (19/46), respectively. Forty-six isolates had 12 different PFGE genotypes. The results above suggested that the hospital environment and patients contributed to nosocomial infections, and the spread of resistance genes in the hospital was common.

摘要

鲍曼不动杆菌是一种重要的医院病原体,能够在重症监护病房(ICU)引起严重感染。然而,目前缺乏对呼吸内科ICU中鲍曼不动杆菌的流行病学和耐药性分析。在本研究中,收集了2009年1月至2010年12月西南医院呼吸内科ICU的临床分离株,并从西南医院信息系统中获取了分离株来源患者的社会和人口统计学信息。采用琼脂稀释法测定分离株的最低抑菌浓度(MIC)。使用PCR扩增这些分离株的碳青霉烯酶编码耐药基因。通过脉冲场凝胶电泳(PFGE)分析分离株的克隆关系。从呼吸内科ICU收集了46株分离株,米诺环素和喹诺酮类抗生素对这些分离株具有较高的药敏性。OXA-51、OXA-23和IMP-4基因的检出率分别为100%(46/46)、67.4%(31/46)和41.3%(19/46)。46株分离株有12种不同的PFGE基因型。上述结果表明,医院环境和患者是医院感染的原因,耐药基因在医院内的传播很普遍。

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