ICU环境鲍曼不动杆菌存在情况及耐药基因型调查  

Acinectobacter baummanii in ICU and its drug-resistant genotype

作　　者：贾宁[1] 于季红[1] 谢丽君[1] 索继江[1] 邢玉斌[1] 刘运喜[1] 

机构地区：[1]解放军总医院感染管理与疾病控制科,北京100853

出　　处：《解放军医学院学报》2014年第1期4-6,55,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金面上项目(30972523);国家科技重大专项课题项目(2009ZX10004-204)~~

摘　　要：目的了解监护室环境中鲍曼不动杆菌的存在状况及其耐药表型和基因型。方法于2010年10月-2011年10月,每隔2周对外科监护室、神经内科监护室和呼吸科监护室病人周边环境进行采样并分离鲍曼不动杆菌;对所分离的菌株进行抗生素敏感试验和耐药基因IMP、SIM、VIM、OXA-23、24、51、58检测。结果 3个监护室病人周边环境共采集标本7 878份,共分离鲍曼不动杆菌229株,其中呼吸科监护室分离率(5.41%)高于外科监护室(2.39%)和神内监护室(2.56%)(P<0.001)。抗生素敏感性除对多黏菌素(67%)相对较高以外,其余普遍较低;金属酶IMP和VIM基因检出率为20.52%和11.36%,未检出SIM基因;苯唑西林酶(OXA群)基因OXA-51分离率为32.75%(75/229)、OXA-23分离率为31.44%(72/229)、OXA-58分离率为3.49%(8/229),未检出OXA-24、AmpC和CTX-M。结论监护室环境菌株的污染和耐药现状较为严重,应加强日常环境清洁消毒工作,防止鲍曼不动杆菌暴发和感染率的升高。Objective To investigate the Acinetobacter baummanii in ICU and its drug-resistant phenotype and genotype. Methods Acine- tobacter baummanii was isolated every two weeks in surgical ICU, neurological ICU and respiratory ICU in our hospital from October 2010 to October 2011. The antibiotic sensitivity was tested and the drug-resistant genes （IMP, SIM, VIM, OXA-23, 24, 51, and 58） were detected. Results A total of 7 878 samples were collected from 3 ICUs, from which 229 Acinectobacter baummanii strains were isolated. The rate of Acinectobacter baummanii strains isolated in respiratory ICU was significantly higher than those isolated in surgical ICU and neurological ICU （5.41% vs 2.39%, 5.41% vs 2.56%, P 〈 0.001）. The resistance of Acinectobacter baummanii strains to polymyxin was 67% and rather low to other antibiotics. The detection rate of IMP, VIM, and OXA -51, OXA- 23, OXA-58 was 20.52%, 11.36%, and 32.75% （75/229）, 31.44% （72/229）, 3.49% （8/229）, respectively. No SIM, OXA-24, AmpC and CTX-M genes were detected. Conclusion The contamination of Acinectobacter baummanii is severe in ICU and its drug resistance is high, daily disinfection of ICU should thus be strengthened in order to prevent outbreak of Acinectobacter banmmanii infection.

关 键 词：鲍曼不动杆菌 耐药 基因型 

分 类 号：R446.5[医药卫生—诊断学]