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伊朗马西赫·达内什瓦里医院囊性纤维化患者中洋葱伯克霍尔德菌所致医院感染暴发的鉴定与分子流行病学研究

Identification and molecular epidemiology of nosocomial outbreaks due to Burkholderia cepacia in cystic fibrosis patients of Masih Daneshvary Hospital, Iran.

作者信息

Dallal M M Soltan, Telefian C F, Hajia M, Kalantar E, Dehkharghani A R Dolatyar, Forushani A Rahimi, Khanbabaei Q, Mobarhan M, Farzami M R

出版信息

J Prev Med Hyg. 2014 Mar;55(1):27-30.

Abstract

INTRODUCTION

B. cepacia complex have emerged as an important opportunistic pathogen in hospitalized and immunocompromised patients. Small hospital outbreaks are frequent and are usually due to a single contaminated environmental source. In this study we were going to investigate the role of B.cepacia complex in those patients suspected to involve with cystic fibrosis and evaluate responsible types in Masih Daneshvary Hospital.

METHODS

One hundred specimens were collected from all admitted patients who were suspected to cystic fibrosis to Masih Daneshvary hospital during one year April 2011 till end of March 2012. All were culture and identified standard procedure. All samples were checked by API system (API20NE) and by specific PCR method for genus Bulkhorderia and Bcc as well. Identified strains were finally tested by PFGE system to identifying specific involving pulse-types.

RESULT

. Isolation and identification methods revealed 5 specimens were B.cepasia, The frequency of the cystic fibrosis detected at this study was lower than other similar study previously reported. All these isolates showed similar pattern by PFGE standard protocol that may have spread from a single source and could not be attributed to cross infections from patient to patients.

DISCUSSION

Application of PFGE and identification of pulse-type is a potential tool to enhance the investigation of apparent nosocomial outbreaks of B.cepacia. However it needs to be adjusted with environmental findings. Implementation of educational programs and adherence to infection control policies are obviously the main element for complete elimination of an outbreak.

摘要

引言

洋葱伯克霍尔德菌复合体已成为医院住院患者和免疫功能低下患者中的重要机会致病菌。小型医院感染暴发频繁,通常是由于单一受污染的环境源所致。在本研究中,我们将调查洋葱伯克霍尔德菌复合体在那些疑似患有囊性纤维化的患者中的作用,并评估马西赫·达内什瓦里医院中的相关菌株类型。

方法

在2011年4月至2012年3月底的一年时间里,从马西赫·达内什瓦里医院所有疑似患有囊性纤维化的住院患者中采集了100份标本。所有标本均采用标准程序进行培养和鉴定。所有样本均通过API系统(API20NE)以及针对伯克霍尔德菌属和洋葱伯克霍尔德菌复合体的特异性PCR方法进行检测。最终通过脉冲场凝胶电泳(PFGE)系统对鉴定出的菌株进行检测,以确定特定的脉冲型。

结果

分离和鉴定方法显示有5份标本为洋葱伯克霍尔德菌。本研究中检测到的囊性纤维化的发生率低于先前报道的其他类似研究。所有这些分离株通过PFGE标准方案显示出相似的模式,可能来自单一来源,而非患者之间的交叉感染。

讨论

PFGE的应用和脉冲型的鉴定是加强对洋葱伯克霍尔德菌明显医院感染暴发调查的潜在工具。然而,这需要与环境调查结果相协调。实施教育计划和遵守感染控制政策显然是彻底消除感染暴发的主要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a54/4718333/992a872b05be/1121-2233-55-27-g001.jpg

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