鲍曼不动杆菌多态性DNA指纹图与药敏谱对医院感染管理的指导作用  

Using DNA Fingerprinting Techniques and Drug-Resistant Profiles for the Management of Infection by Acinetobacter baumannii

作　　者：高霞[1] 谢妮[1] 张洪[1] 肖增簧[2] 秦超[1] 

机构地区：[1]广东省深圳市第二人民医院检验科,深圳518035 [2]暨南大学第一附属医院临检中心,广州510632

出　　处：《热带医学杂志》2008年第2期135-138,共4页Journal of Tropical Medicine

基　　金：深圳市科技计划项目医疗卫生类基金(No.200702116)

摘　　要：目的建立鲍曼不动杆菌(Acinetobacterbaumannii,AB)药敏谱及基因分型指纹图谱,探讨其对医院感染管理的指导作用。方法收集2006年9月至2007年9月神经外科病房住院患者标本中分离的29株AB以及同年从该病房环境中分离的21株AB,以3个月为一期,采用随机扩增多态性DNA(RAPD)技术,对医院环境中AB和临床标本中分离的AB进行基因分型并建立DNA指纹图谱,同时结合WHO推荐的K-B法进行药敏试验,建立药敏谱,比较临床标本中AB与环境中分离的AB药敏谱与RAPD型间差异,判断相关性,并从中分析对医院感染管理的作用。结果临床标本中AB的药敏谱及分型指纹图谱与环境中AB的药敏谱及分型指纹图谱呈现相关关系。29株临床分离的AB共分12种基因型,15种抗菌药物药敏谱分18个型;呈单一对应关系有10种,一对二的对应关系有2种;二对一的对应关系有一种。21株环境中分离的AB共分10种基因型,15种抗菌药物药敏谱分14个型;呈单一对应关系的有8种,一对二的对应关系的有3种,多株临床标本中AB与环境中AB具有同源性。结论依据AB药敏谱及DNA分型指纹图谱对感染源的确定、防止耐药菌传播和制定一系列防治措施具有极为重要的指导意义。Objective To establish the DNA fingerprints and drug-resistant profiles of Acinetobacter baumannii, and to discuss its application in the management of hospital infection. Method Twenty-nine A. baumannii isolates obtained from the patients receiving neurosurgery and 21 A.baumannii isolates from the sickroom of neurosurgery between September 2006 and September 2007 were analyzed. Analysis was performed in a 3-month interval. The genotypes and DNA fingerprints were determined using random amplified polymorphic DNA （RAPD） technique. The WHO recommended K-B method was also used in the construction of drug-resistant profiles. Result There is a correlation of the drug-resistant profiles and the DNA fingerprints between the samples obtained from the patients and from the sickrooms. A total of 12 genotypes and 18 drug-resistant phenotypes were distinguished among the 29 clinical isolates. For the 21 isolates obtained from the sickroom, the isolates would be grouped into 10 genotypes and 14 drug-resistant phenotypes. DNA sequences of several clinical isolates were found to be homologous to the isolates obtained from the sickroom. Conclusion The DNA fingerprints and the drug-resistant profiles of A.baumannii are not only useful in the determination of source of infection, but are also useful in the control of infection in the hospital.

关 键 词：鲍曼不动杆菌 随机扩增多态性DNA技术 感染控制 基因分型 药物敏感试验 

分 类 号：R446.5[医药卫生—诊断学]