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[醋酸钙不动杆菌-鲍曼不动杆菌复合体医院菌株的鉴定与分型]

[Identification and typing of hospital strains of Acinetobacter calcoaceticus-Acinetobacter baumanni complex].

作者信息

Nemec A, Urbásková P, Grimont F, Vránková J, Melter O, Schindler J

机构信息

Státní zdravotní ústav, Praha.

出版信息

Epidemiol Mikrobiol Imunol. 1996 May;45(2):71-82.

PMID:8756404
Abstract

A collection of 95 strains of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex, isolated between 1991 and 1993 in the Prague Burn Center (BC), was studied. Ninety-one strains were isolated from 43 patients: 50 of them from burnt sites, 22 from endotracheal tube, 13 from urine, 3 from blood and 3 from venous catheter, and 4 strains were isolated from the hospital environment and the nursing staff. The strains were classified by restriction endonuclease fingerprinting of total DNA, plasmid profile analysis, ribotyping, comparison of antibiograms, biotyping and according to epidemiological data, into 31 relatedness groups each of them including 1 to 29 strains, likely to be isolates of the same strain. None of the methods used enabled to distinguish all groups. The importance of the polyphasic approach is emphasized since three multiresistant strains, isolated almost simultaneously in the BC, needed at least two methods to be distinguished (e.g. ribotyping and biotyping). Twenty-eight representative strains of different groups were identified by ribotyping: 18 of them were allocated to genomospecies 2 (A. baumannii), 5 to genomospecies 3 and 5 to genomospecies 13 sensu Tjernberg and Ursing. Only A. baumannii was found to spread among patients. Strains of two multiresistant groups persisted in the BC throughout the period studied and strains of one of these groups were responsible for an outbreak in the autumn of 1993. The methods mentioned above were used to describe 12 multiresistant strains isolated in three hospital wards in other localities. When ribotyped these strains were identified as A. baumannii. The strains of the same origin were identical in their typing profiles while the strains of different origins were easy to differentiate using any of the above methods; nevertheless, 2 of these groups were almost identical to 2 groups of multiresistant strains isolated in the BC.

摘要

对1991年至1993年期间在布拉格烧伤中心(BC)分离出的95株醋酸钙不动杆菌-鲍曼不动杆菌复合体菌株进行了研究。91株菌株从43名患者中分离得到:其中50株来自烧伤部位,22株来自气管内导管,13株来自尿液,3株来自血液,3株来自静脉导管,4株来自医院环境和护理人员。通过对总DNA进行限制性内切酶指纹图谱分析、质粒图谱分析、核糖体分型、抗菌谱比较、生物分型并根据流行病学数据,将这些菌株分为31个相关性组,每组包括1至29株,可能是同一菌株的分离株。所使用的任何方法都无法区分所有组。强调了多相方法的重要性,因为在BC几乎同时分离出的三株多重耐药菌株需要至少两种方法才能区分(例如核糖体分型和生物分型)。通过核糖体分型鉴定了28株来自不同组的代表性菌株:其中18株被归为基因种2(鲍曼不动杆菌),5株归为基因种3,5株归为Tjernberg和Ursing意义上的基因种13。仅发现鲍曼不动杆菌在患者中传播。在整个研究期间,两个多重耐药组的菌株在BC持续存在,其中一个组的菌株在1993年秋季引发了一次暴发。上述方法用于描述在其他地区的三个医院病房中分离出的12株多重耐药菌株。核糖体分型时,这些菌株被鉴定为鲍曼不动杆菌。相同来源的菌株在分型图谱上相同,而不同来源的菌株使用上述任何一种方法都易于区分;然而,其中2个组与在BC分离出的2个多重耐药菌株组几乎相同。

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