医院感染鲍曼不动杆菌的分子流行病学研究.docVIP

鲍曼不动杆菌的基因分型及耐药性分析 张婧 徐丁 田菲 韩立中 倪语星 郭晓奎 (上海交通大学医学院, 上海 200025) 作者简介: 张婧(1987-)，女，临床医学八年制在读学生，从事分子流行病学研究; 田菲, 通讯作者, Email: ceci@sjtu.edu.cn [摘要] 目的 分析上海某综合性医院不同科室来源的鲍曼不动杆菌菌株的同源性及耐药状况，了解鲍曼不动杆菌院内感染流行情况。方法 采用重复序列PCR技术（REP-PCR），对51株临床分离的鲍曼不动杆菌菌株进行基因分型，并用纸片扩散法进行药敏试验。结果 51株鲍曼不动杆菌分为13个基因型，其中A型16株，为主要流行型别；C型、D型各6株；M型有5株；E型、F型和G型各3株； B型、H型和K型2株；I型、J型、L型各1株。药敏试验结果显示分离出的菌株对常用抗菌药呈现出多重耐药的现象。其中对阿米卡星和亚胺培南的耐药性最低，均为33.3%；对头孢唑啉耐药性最高，为100%。结论 鲍曼不动杆菌基因的同源性分析表明，该院存在着以A型鲍曼不动杆菌为主的感染流行，估计该型菌株可能以克隆株的形式播散。鲍曼不动杆菌的耐药性很强，应加强其耐药性监测，合理使用抗菌药物。 [关键词] 鲍曼不动杆菌、基因型、重复PCR指纹图、耐药性、医院感染 Study on the genotypes and antibiotic resistance of Acinetobacter baumannii ZHANG Jing, XU Ding, TIAN Fei, HAN Li-zhong, NI Yu-xing, GUO Xiao-kui (Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China) [Abstract] Objective To study genotypes and resistant trend to antibiotics of Acinetobacter baumannii from different departments in a hospital in Shanghai, and evaluate the prevalence of A. baumannii nosocomial infection(NI). Methods Fifty-one strains isolated from patients were typed by genomic DNA by using the repetitive extragenic palindromic PCR (REP-PCR) and tested by K-B for drug susceptibility and identified according to the new standard of CLSI 2004. Results Fifty-one strains of A. baumannii were divided into 13 genetypes by REP-PCR. Among them, 16 strains were type A, which is the major type. Type C and D had 6 strains each; Type E，F and G were 3 strains; Type B, H and K were 2 strains; the other types were only 1 strain. The rate of resistance to Amikacin and Imipenem were the lowest (33.3%). The rate of resistance to Cefazolin was the highest (100%) Conclusion In this hospital there was the prevalence of a certain genotype of A. baumannii, and it can be clonal dissemination. Its resistant trend to antibiotics is developing to multidrug resistance with complicated resistant mechanism. Thus attention should be paid to this pathogen. [Key Words] Acinetobacter baumannii; Genotype; REP-PCR; Dr