某医院重症监护病房耐碳青霉烯类鲍氏不动杆菌耐药性及同源性分析  

Drug resistance and homology of carbapenem-resistant Acinetobacter baumannii strains from intensive care unit of a hospital

作　　者：杨丽芳 刘卫平 YANG Li-fang;LIU Wei-ping(Inner Mongolia Medical University,Hohhot,Inner Mongolia O10010,China;不详)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010010 [2]内蒙古自治区人民医院医院感染控制科,内蒙古呼和浩特010010

出　　处：《中华医院感染学杂志》2024年第17期2580-2583,共4页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区卫生健康科技计划项目(202201024);内蒙古自治区人民医院院内基金项目(2021YN03)。

摘　　要：目的了解某医院重症监护病房(ICU)耐碳青霉烯类鲍氏不动杆菌(CRAB)临床标本及环境标本中CRAB分布、耐药性及同源性。方法对2020年1月-2022年12月内蒙古自治区人民医院ICU患者及同期环境分离的CRAB进行耐药性分析及脉冲凝胶电泳(PFGE)分型。结果共分离CRAB 846株,主要来自痰标本,占所有标本75.30%;主要分布在神外重症(34.16%)、呼吸重症(24.35%)和综合重症(18.68%);CRAB仅对磺胺类、左氧氟沙星、环丙沙星耐药率稍低,在80%~90%左右;对其他常见抗菌药物耐药率均在95%以上;34株CRAB PFGE聚类分析共得到A-J 7个类型,以C聚类为主(11株占32.35%),其次为E聚类(7株20.59%)。结论医院CRAB临床标本神经外科ICU和呼吸与危重症医学科ICU检出率较高,耐药较为严重,且存在患者间、患者与环境间交叉传播,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 investigate the distribution of carbapenem-resistant Acinetobacter baumannii(CRAB)strains in clinical specimens and environmental specimens from intensive care unit(ICU)of a hospital and analyze the drug resistance and homology.METHODS The CRAB strains were isolated from the environment and patients who were treated in ICU of the People′s Hospital of Inner Mongolia Autonomous Region from Jan 2020 to Dec 2022,the drug resistance of the strains was analyzed,and the pulse field gel electrophoresis(PFGE)typing was carried out for the strains.RESULTS Totally 846 strains of CRAB were isolated,75.30%of which were isolated from sputum specimens.Among the isolated CRAB strains,34.16%were isolated from neurosurgery critical care department,24.35%were isolated from respiratory critical care department,and 18.68%were isolated from comprehensive critical care department.The drug resistance rates of the CRAB strains to sulfonamides,levofloxacin and ciprofloxacin were relatively low,ranging between 80%and 90%;the drug resistance rates to other common antibiotics were more than 95%.PFGE clustering analysis of the 34 strains of CRAB showed that totally 7 types from A to J were acquired,which was dominated by C cluster(11 strains,32.35%),followed by E cluster(7 strains,20.59%).CONCLUSION The isolation rates of CRAB strains are high in the clinical specimens from the patients of neurosurgery ICU and critical care medicine ICU.The strains show high drug resistance rates.There is cross transmission among the patients and between the patients and the environment.It is necessary for the hospital to strengthen the disinfection of the environment and surfaces of medical devices and intensify hand hygiene awareness of health care workers so as to prevent the outbreak of nosocomial infection.

关 键 词：重症监护病房 耐碳青霉烯类鲍氏不动杆菌 耐药性 同源性 脉冲凝胶电泳 

分 类 号：R378[医药卫生—病原生物学]