皮特不动杆菌、医院不动杆菌感染的临床特点及同源性
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摘要
目的了解某院皮特不动杆菌、医院不动杆菌感染的临床特点及其同源性。方法收集2016年1—12月分离自该院临床送检感染标本的335株醋酸钙不动杆菌-鲍曼不动杆菌复合群(ACB)非重复菌株,采用16S-23S rRNA基因间隔区序列分析鉴定到种,比较皮特不动杆菌、医院不动杆菌和鲍曼不动杆菌培养阳性患者的临床资料及实验室检查结果,采用PCR方法检测3种细菌OXA-51基因,并采用随机扩增多态性DNA(RAPD)技术分析皮特不动杆菌和医院不动杆菌的同源性。结果 335株ACB包括皮特不动杆菌18株,医院不动杆菌23株和鲍曼不动杆菌284株,其他不动杆菌10株。鲍曼不动杆菌和皮特不动杆菌/医院不动杆菌分离患者间ICU入住率、侵入性操作情况、肺部感染率、住院期间死亡率比较,差异均有统计学意义(均P <0. 05);皮特不动杆菌和医院不动杆菌对大多数抗菌药物的耐药率低于鲍曼不动杆菌。皮特不动杆菌和医院不动杆菌均未见OXA-51基因扩增阳性,284株鲍曼不动杆菌OXA-51基因PCR检测均阳性。RAPD技术将皮特不动杆菌和医院不动杆菌分为4个不同的克隆,同源性分析显示,克隆A和克隆F分别为皮特不动杆菌、医院不动杆菌的流行株。结论皮特不动杆菌和医院不动杆菌应被视为与鲍曼不动杆菌不同的临床菌株而区分对待,OXA-51基因扩增可以考虑作为一种简便快捷的分子生物学技术用于皮特不动杆菌和医院不动杆菌的快速鉴定。应加强对皮特不动杆菌和医院不动杆菌的监控。
Objective To understand clinical features and homology of Acinetobacter pittii(A. pittii) and Acinetobacter nosocomialis( A. nosocomialis) infection in a hospital. Methods A total of 335 non-duplicate clinical isolates of Acinetobacter calcoaceticus-Acinetobacter baumannii complex( ACB) were collected from a hospital between January 2016 and December 2016,species were identified by 16S-23 S rRNA gene spacer sequence analysis,clinical data and laboratory detection results of A. pittii,A. nosocomialis and A. baumannii were compared,OXA-51 gene of three kinds of bacteria was detected by polymerase chain reaction( PCR),homology between A. pittii and A. nosocomialis was analyzed by randomly amplified polymorphic DNA( RAPD). Results Among 335 ACB strains,18,23,284,and 10 were A. pittii,A. nosocomialis,A. baumannii,and other Acinetobacter respectively. There were significant differences in admission rate of intensive care unit( ICU),invasive operation,pulmonary infection rate,and mortality during hospitalization period between patients with infection of A. baumannii and A. nosocomialis( all P < 0. 05). Resistance rates of A. pittii and A. nosocomialis to most antimicrobial agents were lower than those of A. baumannii. No positive amplification of OXA-51 gene was found in A. pittii and A. nosocomialis,PCR detection was positive in OXA-51 gene of 284 strains of A. baumannii. A. pittii and A.nosocomialis were divided into four different clones by RAPD detection,homology analysis showed that clone A and clone F were epidemic strains of A. pittii and A. nosocomialis respectively. Conclusion A. pittii and A. nosocomialis should be considered as different clinical strains from A. baumannii,amplification of OXA-51 gene can be used as a simple and rapid molecular biological technique for rapid identification of A. pittii and A. nosocomialis. Surveillance of A. pittii and A. nosocomialis should be strengthened.
Objective To understand clinical features and homology of Acinetobacter pittii(A. pittii) and Acinetobacter nosocomialis( A. nosocomialis) infection in a hospital. Methods A total of 335 non-duplicate clinical isolates of Acinetobacter calcoaceticus-Acinetobacter baumannii complex( ACB) were collected from a hospital between January 2016 and December 2016,species were identified by 16S-23 S rRNA gene spacer sequence analysis,clinical data and laboratory detection results of A. pittii,A. nosocomialis and A. baumannii were compared,OXA-51 gene of three kinds of bacteria was detected by polymerase chain reaction( PCR),homology between A. pittii and A. nosocomialis was analyzed by randomly amplified polymorphic DNA( RAPD). Results Among 335 ACB strains,18,23,284,and 10 were A. pittii,A. nosocomialis,A. baumannii,and other Acinetobacter respectively. There were significant differences in admission rate of intensive care unit( ICU),invasive operation,pulmonary infection rate,and mortality during hospitalization period between patients with infection of A. baumannii and A. nosocomialis( all P < 0. 05). Resistance rates of A. pittii and A. nosocomialis to most antimicrobial agents were lower than those of A. baumannii. No positive amplification of OXA-51 gene was found in A. pittii and A. nosocomialis,PCR detection was positive in OXA-51 gene of 284 strains of A. baumannii. A. pittii and A.nosocomialis were divided into four different clones by RAPD detection,homology analysis showed that clone A and clone F were epidemic strains of A. pittii and A. nosocomialis respectively. Conclusion A. pittii and A. nosocomialis should be considered as different clinical strains from A. baumannii,amplification of OXA-51 gene can be used as a simple and rapid molecular biological technique for rapid identification of A. pittii and A. nosocomialis. Surveillance of A. pittii and A. nosocomialis should be strengthened.
引文
[1] Wisplinghoff H,Paulus T,Lugenheim M,et al. Nosocomial bloodstream infections due to Acinetobacter baumannii,Acinetobacter pittii and Acinetobacter nosocomialis in the United States[J]. J Infect,2012,64(3):282-290.
[2] Ko WC,Lee NY,Su SC,et al. Oligonucleotide array-based identification of species in the Acinetobacter calcoaceticus-A. baumannii complex in isolates from blood cultures and antimicrobial susceptibility testing of the isolates[J]. J Clin Microbiol,2008,46(6):2052-2059.
[3] Park KH,Shin JH,Lee SY,et al. The clinical characteristics,carbapenem resistance,and outcome of Acinetobacter bacteremia according to genospecies[J]. Plo S One,2013,8(6):e65026.
[4] Karah N,Haldorsen B,Hegstad K,et al. Species identification and molecular characterization of Acinetobacter spp. blood culture isolates from Norway[J]. J Antimicrob Chemother,2011,66(4):738-744.
[5] Pailhoriès H,Tiry C,Eveillard M,et al. Acinetobacter pittii isolated more frequently than Acinetobacter baumannii in blood cultures:the experience of a French hospital[J]. J Hosp Infect,2018,99(3):360-363.
[6] Chen L,Yuan J,Xu Y,et al. Comparison of clinical manifestations and antibiotic resistances among three genospecies of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex[J].PLo S One,2018,13(2):e0191748.
[7]朱善军,倪晓艳,吴巧珍,等.吴江地区多重耐药鲍曼不动杆菌碳青霉烯酶基因型携带情况及同源性[J].中国感染控制杂志,2016,15(12):913-916.
[8]金亮,李达,王勇雁,等. 2012~2016年鲍曼不动杆菌分布及耐药变化趋势分布[J].临床输血与检验,2017,19(6):585-589.
[9]吴伟根,黄永禄,杨旭峰,等.基质辅助激光解吸/电离飞行时间质谱仪在醋酸钙鲍曼不动杆菌复合群鉴定中的应用研究[J].中华检验医学杂志,2013,36(12):1115-1119.
[10] Grundmann HJ,Towner KJ,Dijkshoorn L,et al. Multicenter study using standardized protocols and reagents for evaluation of reproducibility of PCR-based fingerprinting of Acinetobacter spp.[J]. J Clin Microbiol,1997,35(12):3071-3077.
[11] Nemec A,Krizova L,Maixnerova M,et al. Genotypic and phenotypic characterization of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex with the proposal of Acinetobacter pittii sp. nov.(formerly Acinetobacter genomic species 3)and Acinetobacter nosocomialis sp. nov.(formerly Acinetobacter genomic species 13TU)[J]. Res Microbiol,2011,162(4):393-404.
[12] Golanbar GD,Lam CK,Chu YM,et al. Phenotypic and molecular characterization of Acinetobacter clinical isolates obtained from inmates of California correctional facilities[J]. J Clin Microbiol,2011,49(6):2121-2131.
[13]王贺,王辉,徐英春,等.自动化细菌鉴定仪和碳青霉烯酶基因OXA-51扩增在不动杆菌属细菌鉴定中的价值[J].中华检验医学杂志,2009,32(1):83-87.
[14]邓德耀,袁文丽,张唤.医院感染pittii不动杆菌的研究进展[J].中华医院感染学杂志,2015,25(1):238-240.
[15]潘冬青,王水珠.以肺部感染控制窗为切换点序贯机械通气治疗慢性阻塞性肺疾病并严重呼吸衰竭的体会[J].中国医药指南,2011,9(26):281-282.
[16] Akbari M,Niakan M,Taherikalani M,et al. Rapid identification of Iranian Acinetobacter baumannii strains by single PCR assay using BLA OXA-51-like carbapenemase and evaluation of the antimicrobial resistance profiles of the isolates[J]. Acta Microbiol Immunol Hung,2010,57(2):87-94.
[17]邓德耀,袁文丽,刘春林. OXA-51型β内酰胺酶的研究进展[J].中国感染与化疗杂志,2014,14(5):451-454.
[2] Ko WC,Lee NY,Su SC,et al. Oligonucleotide array-based identification of species in the Acinetobacter calcoaceticus-A. baumannii complex in isolates from blood cultures and antimicrobial susceptibility testing of the isolates[J]. J Clin Microbiol,2008,46(6):2052-2059.
[3] Park KH,Shin JH,Lee SY,et al. The clinical characteristics,carbapenem resistance,and outcome of Acinetobacter bacteremia according to genospecies[J]. Plo S One,2013,8(6):e65026.
[4] Karah N,Haldorsen B,Hegstad K,et al. Species identification and molecular characterization of Acinetobacter spp. blood culture isolates from Norway[J]. J Antimicrob Chemother,2011,66(4):738-744.
[5] Pailhoriès H,Tiry C,Eveillard M,et al. Acinetobacter pittii isolated more frequently than Acinetobacter baumannii in blood cultures:the experience of a French hospital[J]. J Hosp Infect,2018,99(3):360-363.
[6] Chen L,Yuan J,Xu Y,et al. Comparison of clinical manifestations and antibiotic resistances among three genospecies of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex[J].PLo S One,2018,13(2):e0191748.
[7]朱善军,倪晓艳,吴巧珍,等.吴江地区多重耐药鲍曼不动杆菌碳青霉烯酶基因型携带情况及同源性[J].中国感染控制杂志,2016,15(12):913-916.
[8]金亮,李达,王勇雁,等. 2012~2016年鲍曼不动杆菌分布及耐药变化趋势分布[J].临床输血与检验,2017,19(6):585-589.
[9]吴伟根,黄永禄,杨旭峰,等.基质辅助激光解吸/电离飞行时间质谱仪在醋酸钙鲍曼不动杆菌复合群鉴定中的应用研究[J].中华检验医学杂志,2013,36(12):1115-1119.
[10] Grundmann HJ,Towner KJ,Dijkshoorn L,et al. Multicenter study using standardized protocols and reagents for evaluation of reproducibility of PCR-based fingerprinting of Acinetobacter spp.[J]. J Clin Microbiol,1997,35(12):3071-3077.
[11] Nemec A,Krizova L,Maixnerova M,et al. Genotypic and phenotypic characterization of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex with the proposal of Acinetobacter pittii sp. nov.(formerly Acinetobacter genomic species 3)and Acinetobacter nosocomialis sp. nov.(formerly Acinetobacter genomic species 13TU)[J]. Res Microbiol,2011,162(4):393-404.
[12] Golanbar GD,Lam CK,Chu YM,et al. Phenotypic and molecular characterization of Acinetobacter clinical isolates obtained from inmates of California correctional facilities[J]. J Clin Microbiol,2011,49(6):2121-2131.
[13]王贺,王辉,徐英春,等.自动化细菌鉴定仪和碳青霉烯酶基因OXA-51扩增在不动杆菌属细菌鉴定中的价值[J].中华检验医学杂志,2009,32(1):83-87.
[14]邓德耀,袁文丽,张唤.医院感染pittii不动杆菌的研究进展[J].中华医院感染学杂志,2015,25(1):238-240.
[15]潘冬青,王水珠.以肺部感染控制窗为切换点序贯机械通气治疗慢性阻塞性肺疾病并严重呼吸衰竭的体会[J].中国医药指南,2011,9(26):281-282.
[16] Akbari M,Niakan M,Taherikalani M,et al. Rapid identification of Iranian Acinetobacter baumannii strains by single PCR assay using BLA OXA-51-like carbapenemase and evaluation of the antimicrobial resistance profiles of the isolates[J]. Acta Microbiol Immunol Hung,2010,57(2):87-94.
[17]邓德耀,袁文丽,刘春林. OXA-51型β内酰胺酶的研究进展[J].中国感染与化疗杂志,2014,14(5):451-454.
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