重症监护病房洋葱伯克霍尔德菌爆发感染的分子流行病学分析  

Molecular epidemiological survey of Burkholderia cepacia infection outbreak in intensive care unit

作　　者：朱以军[1] 单小云[1] 应华永[1] 孙冬梅[1] 郑雅萍[1] 卜黎红[1] 马闪珊[1] 童碧君 

机构地区：[1]金华市中心医院检验科,321000

出　　处：《中华危重症医学杂志（电子版）》2014年第2期10-14,共5页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：浙江省公益性技术应用研究计划项目(2012C33023)

摘　　要：目的分析重症监护病房(ICU)分离的洋葱伯克霍尔德菌耐药性和分子流行病学特点。方法对2012年12月至2013年2月金华市中心医院ICU患者分离出的13株洋葱伯克霍尔德菌进行耐药性分析,同时应用聚合酶链反应法进行recA基因检测,扩增产物进行测序并通过基于局部比对算法的搜索工具(BLAST)进行同源性比对。结果 ICU分离的13株洋葱伯克霍尔德菌耐药模式完全一致,除头孢他啶、头孢吡肟、哌拉西林/他唑巴坦、复方新诺明外,洋葱伯克霍尔德菌对氨苄西林、氨曲南、头孢唑林、头孢曲松、头孢替坦、亚胺培南、氨苄西林/舒巴坦、阿米卡星、庆大霉素、妥布霉素、环丙沙星、左氧氟沙星、呋喃妥因等13种常用抗菌药物均表现为耐药。测序结果显示:ICU来源的13株菌株均为同一基因型(Ⅲ型基因),同源性100%;BLAST比对显示,13株菌株recA基因序列与GenBank中洋葱伯克霍尔德菌recA基因序列片段的同源性为99%。结论本院ICU洋葱伯克霍尔德菌爆发感染为同一基因型克隆株所致,该克隆菌株对常用抗菌药物的耐药性强,应用分子流行病学技术追溯其来源对感染的控制和治疗具有重要意义。Objective To analyze the antibiotics resistance and molecular epidemiological characteristics of bacterial strain of Burkholderia cepacia isolated from intensive care unit （ICU） patients. Methods Thirteen clinical isolated bacterial strain of Burkholderia cepacia were collected from ICU patients in Jinhua Municipal Central Hospital from December 2012 to February 2013. The antibiotics resistance was analyzed and the recA gene was detected by polymerase chain reaction. The amplification products were sequenced and the homology comparison were performed with basic local alignment search tool （BLAST）. Results The antibiotics resistant patterns in 13 strains of Burkholderia cepacia were exactly the same. The commonly used antimicrobial agents all showed antibiotics resistance of Burkholderia cepacia except ceftazidime, cefepime, piperacillin /tazobactam, trimethoprim-sulfamethoxazole. Sequence analysis showed that 13 strains of Burkholderia cepacia had the same genotype （genotype Ⅲ） and the homology was 100%. The recA gene sequence homology in Burkholderia cepacia compared to GenBank was 99%. Conclusions The Burkholderia cepacia in ICU of our hospital came from the same genotype and showed high resistance to common antibiotics. The molecular epidemiology techniques can trace epidemic strains source, thereby to control and treat the infection.

关 键 词：洋葱伯克霍尔德菌 重症监护病房 感染 分子流行病学 

分 类 号：R446.5[医药卫生—诊断学]