重症监护病房鲍曼不动杆菌爆发感染的分子流行病学调查研究  

Molecular epidemiological survey of Acinetobacter baumannii infection outbreak in ICU

作　　者：王厚照[1,2] 许树根[1,2] 张玲[2] 欧阳玲[2] 叶冬青[1] 

机构地区：[1]安徽医科大学公共卫生学院,安徽合肥230032 [2]解放军第一七四医院检验科,福建厦门361003

出　　处：《临床和实验医学杂志》2012年第14期1117-1119,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的对重症监护病房(ICU)鲍曼不动杆菌(Ab)的爆发感染分子流行病学进行研究,并为临床防治Ab感染提供依据。方法对ICU集中检出的鲍曼不动杆菌的耐药情况耐药情况进行分析,收集流行病学资料,采用脉冲场凝胶电泳技术对收集菌株进行基因分型。结果 2011年10月从ICU患者连续检出鲍曼不动杆菌7株,同时从ICU呼吸机和床单上、床头柜检出鲍曼不动杆菌3株,有9株鲍曼不动杆菌的耐药表型和基因型基本一样。患者鲍曼不动杆菌检出标本来自呼吸道,对常用抗生素普遍耐药,耐药率达到90%。结论重症监护室由同一株鲍曼不动杆菌引起爆发感染,对临床常用抗菌药物普遍耐药,对碳氢霉烯类的耐药率有显著上升,应引起高度重视,同时采用必要措施切断传播流行。Objective To study the molecular epidemiology of an outbreak infection caused by Acinetobacter baumannii（A.baumannii） in hospital intensive care unite（ICU） in order to provide the basis for the clinical prevention and treatment of A.baumannii infection.Methods The drug resisitance of A.baumannii isolated from ICU was tested.Epidemiological data were collected.Genotyping of the isolates was analyzed by pulsed field gel electrophoresis.Results In October 2011,7 A.baumannii isolates were isolated from respiratory tract of ICU patients,and 3 isolates from ventilator,bed and bedside cupboard in ICU.The phenotype and genotype were essentially the same in 9 isolates.The antimicrobial resistance rate of the isolates was 90.0%,with the resistance rate to carbapenemas significantly increased（P0.05）.Conclusion In this study,A.baumannii infection outbreak in ICU is caused by the same strain and the A.baumannii isolates are highly resistant to all antimicrobials with significantly increased resistance to carbapenemas.It is indicated that necessary measures should be adopted to cut off the spread of the epidemic.

关 键 词：鲍曼不动杆菌 重症监护室 分子流行病学 

分 类 号：R446.5[医药卫生—诊断学] R181.3[医药卫生—临床医学]