多重耐药鲍曼不动杆菌的聚类分析与病例调查
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江苏省卫生厅科研面上项目(H201305);2012年度医院诊疗新技术新项目(院发187号文);科技部科技重大专项“重大新药创制”(2011ZX09302-003-02);江苏高校优势学科建设工程资助项目(JX10231801)


Cluster analysis and case survey of multidrug-resistant Acinetobacter baumannii
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    目的:了解多重耐药鲍曼不动杆菌(multidrug-resistant Acinetobacter baumannii,MDRAB)的同源性与流行病例,为控制医院感染及临床合理用药提供依据-方法:收集2012年6~12月临床分离的31株MDRAB,采用K-B纸片法检测12种抗菌药物敏感性,应用脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)分析菌株的同源性-回顾性分析MDRAB样本病例-结果:药敏结果显示,31株MDRAB对9种抗菌药物100%耐药率,包括4类抗菌药物-PFGE结果表明,31株菌分为5个克隆,20株属于B克隆,占64.52%,为主要流行菌株型,分布于8个病区,主要集中在重症监护病房-胸心外科-老年重症监护病房等重症病区-患者平均年龄64岁,侵入性操作占97%-结论:MDRAB对临床常用抗菌药物耐药比较严重-可能与院内存在克隆传播及患者年龄大-侵入性诊疗操作-合并多种基础疾病等多种因素有关-

    Abstract:

    Objective:To investigate the homology and prevalent cases of multidrug-resistant Acinetobacter baumannii (MDRAB) so as to provide reference for the prevention of nosocomial infection and clinical reasonable application of antibiotics. Methods:A total of 31 MDRAB isolates between June 2012 and December 2012 were collected,the susceptibility test of 12 antimicrobial agents was determined by K-B method,and the homology analysis of the strains was determined by pulsed-field gel electrophoresis(PFGE). Retrospective analysis of MDRAB sample cases was performed. Results:The antimicrobial susceptibility showed that the resistance rate of 31 MDRAB isolates to 9 antibiotics was 100%,including 4 kinds of antibacterial drugs. The results of PFGE demonstrated that 31 isolates were classified into 5 distinct genotypes,among those 20 isolates (accounting for 64.52%) of clone B were the predominant epidemic strains. The patients with MDRAB infection were distributed among 8 wards and mainly centralized in the intensive care unit,cardiothoracic surgery and geriatric intensive care unit. The average age of the patients was 64 years,and 97% of them had undergone invasive procedures. Conclusion:The MDRAB was seriously resistant to almost all clinically-used antibiotics. It may be closely related to a variety of factors,such as clonal spread,old age of patients,invasive treatment and patients with multiple underlying medical conditions.

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王 敏,曹 加,梅亚宁,欧 宁.多重耐药鲍曼不动杆菌的聚类分析与病例调查[J].南京医科大学学报(自然科学版),2014,(6):820-825

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  • 收稿日期:2014-01-20
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  • 在线发布日期: 2014-06-19
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