重症监护室患者血与痰标本中鲍曼不动杆菌分子流行病学与耐药特征分析

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英文篇名：Analysis of molecular epidemiology and drug resistance of Acinetobacter baumannii in blood and sputum specimens of patients in intensive care unit 作者：任亚文 ; 张甲龙 ; 邢方 英文作者：REN Ya-wen;ZHANG Jia-long;XING Fang;Clinical Laboratory Department, People's Hospital of Tongchuan; 关键词：鲍曼不动杆菌 ; 重症监护室 ; 耐药谱 ; 分子流行病学 英文关键词：Acinetobacter baumannii;;intensive care unit;;drug resistance spectrum;;molecular epidemiology 中文刊名：YLYS 英文刊名：Clinical Research and Practice 机构：铜川市人民医院检验科; 出版日期：2019-02-01 出版单位：临床医学研究与实践 年：2019 期：v.4 语种：中文; 页：YLYS201904039 页数：4 CN：04 ISSN：61-1503/R 分类号：102-104+125

摘要

目的分析本院重症监护室(ICU)患者血和痰标本内鲍曼不动杆菌(ABA)分子流行病学和耐药特征,为防治ABA感染提供思路。方法选取2016年2月至2018年2月在本院ICU治疗患者的血与痰标本,分离出非重复ABA 46株,联合多位点序列分型(MLST)技术与脉冲场凝胶电泳(PFGE)对46株ABA行同源性分析,观察46株ABA不同基因分型及耐药谱情况。结果 MLST结果显示46株ABA分属为9个ST型,其中主要为ST195、ST457及STn1,分别有13、13及11株;PFGE结果显示46株ABA可分成3个克隆型,A型为18株,B型为17株,C型共4株,散发非克隆7株。PFGE分型与MLST分型一致性较高,MLST中主要ST457、ST195分型对应PFGE中的A、B型;不同MLST及PFGE分型在耐药谱方面差别不大,都表征是多重耐药,同时PFGE或者MLST相同分型的菌株其耐药谱并不完全一致。结论本院ICU患者血与痰标本中ABA主要克隆分型是ST195与ST457,且不同分型ABA均表征为多重耐药,临床需加强对ICU患者感染控制,降低其传播率。
        Objective To analyze the molecular epidemiology and drug resistance of Acinetobacter baumannii(ABA) in blood and sputum specimens of patients from intensive care unit(ICU) of our hospital, and to provide ideas for the prevention and treatment of ABA infection. Methods Blood and sputum specimens from ICU patients treated in our hospital from February 2016 to February 2018 were selected, 46 strains of non-repetitive ABA were isolated. Analysis of homology of 46 ABA strains by combined multilocus sequence typing(MLST) and pulsed field gel electrophoresis(PFGE), the genotypes and drug resistance profiles of 46 ABA strains were observed. Results MLST results showed that 46 ABA strains belonged to 9 ST types, and the main types were ST195, ST457 and STn1, with 13, 13 and 11 strains respectively; PFGE results showed that 46 ABA strains could be divided into 3 clonal types, 18 strains of type A, 17 strains of type B and 4 strains of type C, with 7 sporadic non-clones. The consistency of PFGE typing and MLST typing was high, the main ST457 and ST195 types in MLST corresponded to A and B types in PFGE. Different MLST and PFGE typing showed little difference in drug resistance spectrum, which was characterized by multiple drug resistance. At the same time, the drug resistance spectrum of PFGE or MLST strains with the same typing was not completely consistent. Conclusion ST195 and ST457 are the main clone types of ABA in blood and sputum specimens of ICU patients in our hospital, and different types of ABA are characterized by multiple drug resistance. It is necessary to strengthen infection control and reduce the transmission rate of ABA in ICU patients.

引文

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