留置导尿患者医院感染铜绿假单胞菌的分子流行病学研究  

A molecular epidemiological study on nosocommial urinary tract infection in urology patients with chronic indwelling urethral catheters

作　　者：魏启欧[1] 蒋虹[1] 卢仙娥 

机构地区：[1]华西医科大学附属第一医院 [2]重庆医科大学临床微生物学教研室 [3]重庆医科大学临床学院流行病学教研室

出　　处：《中华医院感染学杂志》1999年第3期137-139,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金

摘　　要：目的探索留置导尿患者医院感染铜绿假单胞菌（Ｐａ）的感染途径和传播机制。方法从患者小便、脓液、痰液和患者相关环境公用拖帕和洗涤池中共分离出Ｐａ５１株，应用血清学、细菌素、质粒图谱、质粒限制性内切酶图谱、外膜蛋白图谱等方法进行了研究。结果５１株Ｐａ的血清学分型率为８０．４％，细菌素分型率为７７．１％，质粒携带率为６８．６％，呈４种流行模式；来源不同的Ａ、Ｂ、Ｃ三型质粒代表株经用ＥｃｏＲⅠ和ＨｉｎｄⅢ酶切，呈现相同限制性内切酶图谱。９株不同质粒图谱模式菌株，得到两种不同类型外膜蛋白图谱。结论患者与患者之间通过床头柜、床单、导尿管等为媒介，相互交叉感染是导致Ｐａ医院感染的重要因素；一种血清型的细菌可能被分成几种菌素型，同种菌素型也不一定对应于一种血清型；同种血清型的菌株可用质粒图谱分成几种亚型；Ｐａ的外膜蛋白图谱呈高度相似性。OBJECTIVE To investigate the mechanism of nosocomial infection caused by Pseudomonas aeruginosa in patients with chronic indwelling urethral catheters. METHODS A total of fifty-one Pseudomonas aeruginosa strains were separated from both patients' samples and related envirinmental samples. Serotyping, pyocintyping, plasmid profile, plasmid restriction endonuclease profile and outer membrane protein profile were applied to the epidemiological analysis of Pseudomonas aeruginosa. RESULTS The serotyping rate was 80.4%. The pyocin typing rate was 77.1%. About 68.6% separated strains carried plasmid, which could be divided into four subtypes. Strains from the similar plasmid troup had the same Restriction Endonuclease Fragments Profiles. Nine strains with different serotypes were divided into two Outer Membrane Protein Profiles. CONCLUSIONs It is suggested that cross infection among patients is the main way of nosocomial infection. By methodological comparation, the plasmid restriction endonuclease profile is a simple, stable and reliable molecular typing method.

关 键 词：留置导尿 医院感染 铜绿假单胞菌 分子流行病学 

分 类 号：R378.991[医药卫生—病原生物学] R691.3[医药卫生—基础医学]