医院流行的多药耐药鲍氏不动杆菌同源性分析

Homology analysis of the popular multidrug-resistantAcinetobacter baumannii isolated in hospital

  • 摘要: 目的 调查医院临床分离的多药耐药鲍氏不动杆菌(MDRAB)的同源性及β-内酰胺类耐药基因的流行情况,为医院感染管理控制提供依据。方法 选取2013年11-12月医院临床分离9株MDRAB,采用VITEK-2全自动微生物仪进行鉴定和药敏试验,部分抗菌药物的敏感性采用纸片扩散法,采用脉冲场电泳(PFGE)检测MDRAB的同源性,用PCR法检测β-内酰胺类耐药基因,对部分阳性基因进行测序。结果 9株MDRAB中,PFGE谱型有A(8/9)和B(1/9)2种;β-内酰胺类耐药基因OXA-51OXA64组基因均阳性,8株(8/9)OXA-23qc基因阳性、3株(3/9)TEM基因阳性;5株标本来源于ICU,3株标本来源于神经外科病房,1株来自神经内科病房。结论 医院分离的MDRAB存在相同PFGE和携带相同β-内酰胺类耐药基因,医院应重点加强ICU和神经外科病房的消毒隔离。

     

    Abstract: OBJECTIVE To investigate the homology and the prevalence of β-lactamase genes in multidrug-resistant Acinetobacter baumannii(MDRAB)isolated in hospital,so as to provide the basis for the control of nosocomial infections.METHODS A total of 9strains of MDRAB were isolated from Nov.2013 to Dec.2013.Identification and susceptibility tests of bacteria were performed by VITEK2 automated microbial analyzer,and partial antimicrobial drug susceptibility tests were conducted by the disk diffusion method.Homology analysis was performed by pulsed field gel electrophoresis(PFGE),polymerase chain reaction(PCR)was used to detect resistance genes for β-Lactamases,and portion of positive genes were sequenced.RESULTS There were 2types of PFGE profiles in 9strains of MDRAB,including 8strains of type A strain(8/9)and 1strain of type B(1/9).All of these stains carried OXA-51 gene and OXA64 group genes,and OXA-23 qc gene was identified in 8strains(8/9),TEM gene was identified in 3strains(3/9).There were 5(5/9)strains of specimens isolated in ICU,while 3(3/9)strains in neurosurgery ward.CONCLUSION MDRAB strains with the same PFGE profile and the sameβ-lactam resistance genes were existed in this hospital during this time.Hospitals should focus on the disinfection and isolation in ICU and neurosurgery ward.

     

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