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来自重症监护病房空气及患者的耐碳青霉烯类细菌

Carbapenem-resistant from Air and Patients of Intensive Care Units.

作者信息

Jiang Meijie, Mu Yunqing, Li Ning, Zhang Zhijun, Han Shulin

机构信息

Laboratory Medicine, Tai'an City Central Hospital, Tai'an, Shandong, China.

Laboratory Medicine, Dezhou City People's Hospital, Dezhou, Shandong, China.

出版信息

Pol J Microbiol. 2018;67(3):333-338. doi: 10.21307/pjm-2018-040.

Abstract

To understand the molecular epidemiology and antibiotic resistance of air and clinical isolates of Acinetobacter baumannii , the intensive care unit settings of a hospital in Northern China were surveyed in 2014. Twenty non-duplicate A. baumannii isolates were obtained from patients and five isolates of airborne A. baumannii were obtained from the wards' corridors. Pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to analyze the homology relationships of isolates. Resistance and resistance genes were detected by drug susceptibility test and PCR. The results demonstrated that all isolates can be classified into eight PFGE types and four sequence types (ST208, ST195, ST369 and ST530). A pair of isolates from patients (TAaba004) and from the air (TAaba012) that share 100% similarity in PFGE was identified, indicating that air might be a potential and important transmission route for A. baumannii . More than 80% of the isolates were resistant to carbapenems and aminoglycoside antibiotics. Twenty-four isolates, which were resistant to carbapenems, carried the bla OXA-23-like gene. The data indicated that air might be an alternative way for the transmission of A. baumannii . Hospitals should pay more attention to this route, and design new measures accordingly.

摘要

为了解鲍曼不动杆菌空气分离株和临床分离株的分子流行病学及抗生素耐药性,2014年对中国北方一家医院的重症监护病房环境进行了调查。从患者中获得20株非重复的鲍曼不动杆菌分离株,从病房走廊获得5株空气传播的鲍曼不动杆菌分离株。采用脉冲场凝胶电泳(PFGE)和多位点序列分型(MLST)分析分离株的同源关系。通过药敏试验和PCR检测耐药性及耐药基因。结果表明,所有分离株可分为8种PFGE型和4种序列型(ST208、ST195、ST369和ST530)。鉴定出一对PFGE相似度为100%的患者分离株(TAaba004)和空气分离株(TAaba012),表明空气可能是鲍曼不动杆菌潜在的重要传播途径。超过80%的分离株对碳青霉烯类和氨基糖苷类抗生素耐药。24株对碳青霉烯类耐药的分离株携带blaOXA - 23样基因。数据表明空气可能是鲍曼不动杆菌传播的另一种途径。医院应更多关注此传播途径,并据此制定新的措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/7256820/408530b94099/pjm-67-3-333-g001.jpg

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