某三甲医院重点科室耐碳青霉烯类鲍曼不动杆菌耐药性及同源性分析  

Analysis on resistance and homology of carbapenem-resistant Acinetobacter baumannii of key departments of a tertiary hospital

作　　者：刘卫平 宋子璇 杨永芳 张凯 李昊雪 赵宇平 董博伟 任伟 张帅 郭天慧 LIU Wei-ping;SONG Zi-xuan;YANG Yong-fang;ZHANG Kai;LI Hao-xue;ZHAO Yu-ping;DONGBo-wei;REN Wei;ZHANG Shuai;GUO Tian-hui(People's Hospital of Inner Mongolia,Hohhot Inner Mongolia010017,China)

机构地区：[1]内蒙古自治区人民医院,内蒙古呼和浩特010017

出　　处：《中国消毒学杂志》2022年第8期598-601,共4页Chinese Journal of Disinfection

基　　金：传染病预防控制国家重点实验室自主研究项目(2019SKLID305);中国老年医学学会感染防控研究基金资助项目(GRYJ-LRK2018021);内蒙古自治区自然科学基金项目[2017MS(LH)0845];内蒙古自治区人民医院博士科研启动资金项目(BS201804);内蒙古自治区卫生计生科研计划项目(201703006)。

摘　　要：目的了解某三甲医院重点科室耐碳青霉烯类鲍曼不动杆菌(CRAB)的耐药性及同源性。方法回顾性研究2020年1—12月内蒙古自治区人民医院重点科室患者标本及环境标本中分离到的46株CRAB,对菌株进行耐药性分析及脉冲凝胶电泳(PFGE)分型。结果CRAB主要来自痰标本,科室以ICU检出最多;46株CRAB对常见抗菌药物呈高度耐药,仅对左氧氟沙星、复方新诺明、妥布霉素和庆大霉素耐药率稍低,耐药率在80%~90%;PFGE结果显示46株CRAB共分为A—J 10个聚类,其中F聚类是主要的流行型别(17株),其次为G聚类(6株)、B聚类(5株)、H聚类(5株)和E聚类(4株),其余聚类仅含1~3株。结论该院存在科室与科室间、患者与环境间CRAB的交叉传播,应加强院内环境和医疗仪器表面消毒,强化医务人员手卫生意识,防止院内感染的暴发。Objective To understand the drug resistance and homology of carbapenem-resistant Acinetobacter baumannii(CRAB)of key departments of a tertiary hospital.Methods Retrospective investigation was used to analyze forty-six strains of carbapenem-resistant Acinetobacter baumannii isolated from patient specimens and environmental specimens in key departments of the People’s Hospital of Inner Mongolia Autonomous Region from January to December 2020,and the strains were analyzed for drug resistance and typed by pulsed field gel electrophoresis(PFGE).Results CRAB were mainly from sputum specimens,with the most detected in ICU.The 46 strains of CRAB were highly resistant to common antibiotics,with only slightly lower resistance rates to levofloxacin,cotrimoxazole,tobramycin and gentamicin,with resistance rates ranging from 80%to 90%.PFGE results showed that the 46 strains of CRAB were divided into 10 clusters A—J,with cluster F being the main prevalent type(17 strains),followed by cluster G(6 strains),cluster B(5 strains),cluster H(5 strains)and cluster E(4 strains);the remaining clusters contained only 1 to 3 strains.Conclusion Cross transmission of CRAB between departments and between patients and the environment exists in this hospital.The disinfection of the environment and surfaces of medical instruments in the hospital should be strengthened,and the awareness of hand hygiene of medical staff should be reinforced to prevent outbreaks of nosocomial infections.

关 键 词：重点科室 耐碳青霉烯类鲍曼不动杆菌 脉冲凝胶电泳 同源性分析 

分 类 号：R181[医药卫生—流行病学]