白血病病房中对阿米卡星、庆大霉素和妥布霉素耐药的铜绿假单胞菌。流行病学和遗传学研究。

Amikacin, gentamicin and tobramycin resistant Pseudomonas aeruginosa in a leukaemic ward. Epidemiology and genetic studies.

作者信息

Falkiner F R, Jacoby G A, Keane C T, McCann S R

出版信息

J Hosp Infect. 1982 Sep;3(3):253-61. doi: 10.1016/0195-6701(82)90044-5.

Abstract

Four patients in a leukaemic ward were infected with multi-resistant Pseudomonas aeruginosa. Similar organisms were found in the environment and it appeared that lapses in aseptic routine contributed to the outbreak. Serological, bacteriophage and pyocin-typing revealed that a fifth patient was infected with a distinct strain, but agarose gel electrophoresis indicated that all patient and environmental strains carried the same plasmid. The plasmid had a molecular weight of 47 (s.d. +/- 2) X 10(6) dal and was transfer deficient. It conferred resistance to carbenicillin, gentamicin, kanamycin, streptomycin, sulphonamide, tetracycline and tobramycin and determined an aminoglycoside adenylyltransferase active against amikacin in-vitro and not in-vivo. Spread of this non-transferable plasmid to a different Ps. aeruginosa strain and dissemination of multi-resistant organisms led to serious infections.

摘要

白血病病房的4名患者感染了多重耐药的铜绿假单胞菌。在环境中发现了类似的微生物，无菌操作程序的失误似乎导致了此次暴发。血清学、噬菌体和细菌素分型显示，第5名患者感染了一种不同的菌株，但琼脂糖凝胶电泳表明，所有患者和环境菌株都携带相同的质粒。该质粒的分子量为47（标准差±2）×10⁶道尔顿，且缺乏转移能力。它赋予了对羧苄青霉素、庆大霉素、卡那霉素、链霉素、磺胺、四环素和妥布霉素的抗性，并在体外而非体内测定了对阿米卡星有活性的氨基糖苷腺苷转移酶。这种不可转移的质粒传播到不同的铜绿假单胞菌菌株以及多重耐药菌的传播导致了严重感染。