2007-2010年耐亚胺培南鲍氏不动杆菌的分子流行病学研究  

Molecular epidemiology of imipenem-resistant Acinetobacter baumannii infections from 2007 to 2010

作　　者：陈利达[1] 黄彬[1] 陈树林[1] 蔡壬辛[1] 何秋莹[1] 

机构地区：[1]中山大学附属第一医院检验医学部,广东广州510080

出　　处：《中华医院感染学杂志》2013年第15期3561-3563,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查2007-2010年临床分离的耐亚胺培南鲍氏不动杆菌(IRAB)的医院感染暴发与抗菌药物敏感性,为医院感染预防控制和临床用药提供依据。方法采用VITEK-2型全自动微生物检测系统对细菌进行鉴定及药敏分析,采用Whonet 5.4软件筛选2007-2010年对耐亚胺培南鲍氏不动杆菌,采用脉冲场凝胶电泳对耐药菌株进行基因分型,用BioNumeric软件进行聚类分析。结果 2007-2010年136株IRAB主要分离自内科ICU45株,占33.09%,标本类型主要为痰液102株,占75.0%;136株IRAB可分为A～Z共26个型别,主要型别为A型14株、B型16株、C型18株、D型13株、E型11株、F型10株,分别占10.29%、11.76%、13.23%、9.56%、8.09%、7.35%;A型IRAB于2008年4-6月和10-12月在内科ICU两次暴发流行;B型IRAB于2009年5-7月和11-12月在内科ICU两次暴发流行,C型IRAB于2009年6-9月于神经科ICU暴发1次,暴发菌株对绝大多数抗菌药物耐药。结论 2007-2010年中,IRAB于2008和2009年共出现3个型别5次暴发,内科ICU和神经科ICU是医院感染监测和暴发流行预防的重点科室。OBJECTIVE To investigate the outbreak of imipenem-resistant Acinetobacter baumannii （IRAB） infections and the drug susceptibility from 2007 to 2010 so as to provide basis for the prevention and control of nosocomial infections as well as the clinical medication. METHODS The strain identification and the antibiotic sus- ceptibility of bacteria were analyzed by VITEK-2 automatic analyzer. Whonet 5.4 software was employed to screen the imipenem-resistant A. baurnannii between 2007 and 2010. PFGE method was used for strain genotyping. BioNumeric 6.0 software was adopted to analyze the results of genotyping. RESULTS Of 136 strains of IRAB col- lected from 2007 to 2010, 45 （33.09%） strains were isolated from the ICU of internal medicine department, 102 （75.0%） strains were isolated from the sputum specimens. The 136 strains of IRAB were divided into 26 geno- types, among which there were 14 （10.29%） strains of type A, 16 （11.76%） strains of type B, 18 （13.23%） strains of type C, 13 （9.56%） strains of type D, 11 （8.09%） strains of type E, and 10 （7.35M） strains of type E. Type A of IRAB outbreak happened twice from Apt to Jun and from Oct to Dec in 2008, type B of IRAB out- breake happened twice in from.May to Jul and from Nov to Dec in 2009, Type C of IRAB outbreake happened once from Jun to Sep in 2009. Type A and B came from the medical ICU, type C came from the neurological ICU. Most of the prevalence strains were multidrug-resistant. CONCLUSION In the four years from 2007 to 2010, totally three types of IRAB outbreake happened for five times in the hospital. The medical ICU and neurology ICU are the key wards of the outbreak and prevalence to be paid attention to.

关 键 词：鲍氏不动杆菌 亚胺培南 医院感染暴发 耐药 

分 类 号：R181.32[医药卫生—流行病学]