Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
J Hosp Infect. 2017 Jun;96(2):101-110. doi: 10.1016/j.jhin.2017.01.012. Epub 2017 Jan 28.
Multi-drug-resistant Gram-negative bacteria (MDRGNB) have become an important cause of nosocomial infection in intensive care units (ICUs).
To investigate the molecular epidemiology of MDRGNB isolated from medical personnel (MP) and non-medical personnel (NMP) at 69 ICUs in Tianjin, China.
From April 2007 to October 2015, 2636 nasal and hand swab samples from 1185 MP and 133 NMP were cultured for GNB (including MDRGNB), meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The susceptibilities of GNB to 14 antimicrobial agents were determined, and 80 MDRGNB were characterized using pulsed-field gel electrophoresis (PFGE) and dendrogram analysis.
In total, 301 GNB were identified in 269 MP, including 109 MDRGNB isolates in 104 MP. Forty-two GNB were isolated from 39 NMP, which included 20 NMP with MDRGNB. Overall, 8.8% of MP were colonized with MDRGNB, which greatly exceeded colonization rates with MRSA (0.9%) and VRE (0.1%). Three pairs of Klebsiella pneumoniae and one pair of Enterobacter aerogenes were indistinguishable from each other, but the majority of isolate tests had distinct PFGE profiles.
The prevalence of MDRGNB was high among ICU MP in Tianjin, and greatly exceeded that of VRE and MRSA. There was no difference in the rates of nasal carriage of MDRGNB between MP and NMP, but NMP were significantly more likely to have hand colonization with MDRGNB. PFGE profiles showed that there was only limited sharing of strains of MDR E. aerogenes and K. pneumoniae between personnel.
多重耐药革兰氏阴性菌（MDRGNB）已成为重症监护病房（ICU）医院感染的重要原因。
调查中国天津 69 家 ICU 医护人员（MP）和非医护人员（NMP）分离的 MDRGNB 的分子流行病学。
2007 年 4 月至 2015 年 10 月，采集 1185 名 MP 和 133 名 NMP 的鼻拭子和手拭子共 2636 份培养 GNB（包括 MDRGNB）、耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素耐药肠球菌（VRE）。测定 GNB 对 14 种抗菌药物的敏感性，并用脉冲场凝胶电泳（PFGE）和系统发育树分析对 80 株 MDRGNB 进行特征分析。
共鉴定出 269 名 MP 的 301 株 GNB，包括 104 名 MP 的 109 株 MDRGNB 分离株。从 39 名 NMP 中分离出 42 株 GNB，包括 20 株 NMP 的 MDRGNB。总体而言，MP 中 MDRGNB 的定植率为 8.8%，远高于 MRSA（0.9%）和 VRE（0.1%）的定植率。3 对肺炎克雷伯菌和 1 对产气肠杆菌不可区分，但大多数分离株的 PFGE 图谱不同。
天津 ICU MP 中 MDRGNB 的流行率较高，明显高于 VRE 和 MRSA。MP 和 NMP 之间 MDRGNB 鼻携带率无差异，但 NMP 手部 MDRGNB 定植率明显更高。PFGE 图谱显示，MDR 产气肠杆菌和肺炎克雷伯菌菌株之间仅有有限的菌株共享。
