同克隆嗜麦芽寡养单胞菌医院内传播的特点  

Analysis of Features of Nosocomial Infection by Homologous Stenotrophomonas Maltophilia with Same Strain

作　　者：陈愉[1] 王艳玲[2] 周秀珍[2] 孙继梅[2] 张智洁[2] 赵立[1] 李胜岐[1] 

机构地区：[1]中国医科大学附属盛京医院呼吸科,沈阳110004 [2]中国医科大学附属盛京医院检验科,沈阳110004

出　　处：《中国医科大学学报》2011年第6期534-536,共3页Journal of China Medical University

摘　　要：目的探讨嗜麦芽寡养单胞菌在医院内传播的特点及流行途径,为预防医院内暴发流行提供参考。方法对8株来自不同患者的嗜麦芽寡养单胞菌进行脉冲场凝胶电泳同源性分析,通过对染色体DNA限制性内切酶谱进行比较确定菌株亲缘关系。对收集病例的临床资料进行分析,总结传播特点。结果 8株菌特征性指纹图谱带型一致为同源菌株;患者平均年龄65岁,平均住院时间64 d,入重症监护病房5例,入呼吸科3例;所有患者均有基础疾病、曾应用广谱抗生素、行机械通气治疗;重症监护病房分离出的末株菌与首株菌间隔256 d,重症监护病房和呼吸科医生进行过病房之间的会诊及处置。结论有基础疾病、应用广谱抗生素、机械通气是嗜麦芽寡养单胞菌感染的易患因素;同医疗单元环境污染为传播的主要原因;不同医疗单元医源性交叉感染为主要的传播方式。Objective To analyze the features and mode of the spread of Stenotrophomonas maltophilia in hospital settings in order to prevent hospital outbreak. Methods A total of 8 Stenotrophomonas maltophilia swains were analyzed by pulsed-field gel electrophoresis for homology. Panem of chromosomal DNA restriction endonuclease fingerprints was compared to determine genetic relation among the strains. Clinical data were analyzed to summarize the spread features. Results The 8 strains were found homologous by comparison of fingerprints. The mean age of the patients was 65 years old and the average hospital stay was 64 days. Five cases were from intensive care unit and 3 from the department of respiratory diseases. All patients had underlying disease treated by broad spectrum antibiotics and mechanical ventilation. The interval between the fast and the last strain isolated in intensive care unit was 256 days. The doctors of intensive care unit and the department of respiratory diseases had ward consultation and treatment for the patients in each other＇s wards. Conclusion Underlying disease, treatment with broad spectrum antibiotics and mechanical ventilation may be the risk factors of Stenotrophomonas maltophilia infection; Environmental contamination is the main spread mode in the care unit; Iatrogenic cross-transmission is the main spread mode among different care units.

关 键 词：嗜麦芽寡养单胞菌 脉冲场凝胶电泳 传播特点 

分 类 号：R378.2[医药卫生—病原生物学]