产ESBLs大肠埃希菌与肺炎克雷伯菌院内垂直传播分析  

Vertical Dissemination of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extended-spectrum Beta-lactamases in Hospital

作　　者：胡大春[1] 邵剑春[1] 杨绍敏[1] 周玲[1] 刘德华[1] 

机构地区：[1]昆明市第一人民医院,云南昆明650011

出　　处：《中华医院感染学杂志》2006年第3期331-334,共4页Chinese Journal of Nosocomiology

基　　金：昆明市科技局2002年重点科技计划项目(昆科社字2002-01-18)

摘　　要：目的调查产ESBLs大肠埃希菌(ECO)与肺炎克雷伯菌(KPN)院内垂直传播流行状况。方法脉冲场凝胶电泳(PFGE),用Quantity One软件进行PFGE指纹比较分析。结果ICU分离的21株ECO中有10株和7株的相似性系数>90%和100%;KPN有3株相似性系数为100%;神经外科分离的20株ECO中,有9株相似性系数>90%;6株KPN中有4株的相似性系数>90%;干部病房分离的10株ECO中有3株和2株相似性系数>90%和100%;消化科和呼吸科分别在7株和18株ECO中,有2株和2株相似性系数>90%;其他科室也有检出相似性系数>90%的菌株。结论多科室存在垂直传播,尤以ICU病房严重,应采取有力措施加强感染控制管理工作。OBJECTIVE To investigate the epidemic situation of vertical dissemination of the Escherichia coli （ECO） and Klebsiella pneumoniae （KPN） isolates producing extended-spectrum beta-lactamases in the hospital. METHODS The fingerprints of the isolates were obtained by pulsed-field-gel-electrophoresis （PFGE）, and were analyzed with software Quantity One. RESULTS The similarity of 10 isolates and 7 isolates among the 21 ECO isolates from ICU was more than 90%, and 100%, respeetively; the similarity of 3 KPN isolates was 100%. The similarity of 9 isolates among the 20 ECO isolates was more than 90% and the similarity of 4 isolates among the 6 KPN isolates was more than 90% in the neurosurgery ward. The similar coefficients of 3 isolates and 2 isolates among the 10 ECO isolates from the ward for cadre were more than 90% and 100%, respectively. The similar coefficients of 2 isolates among the 7 ECO isolates from the gastroenterology ward and 2 isolates among the 18 ECO isolates from the respiratory ward were more than 90%. The isolates whose similarity was more than 90% were also found in other wards. CONCLUSIONS There are vertical disseminations of single clone of ESBL-producing organisms in several wards, especially in the ICU. It is necessary to strengthen the management of infectioncontrol.

关 键 词：超广谱Β-内酰胺酶 大肠埃希菌 肺炎克雷伯菌 垂直传播 脉冲场凝胶电泳 

分 类 号：R378.2[医药卫生—病原生物学]