ICU耐碳青霉烯类鲍曼不动杆菌同源性研究

目的探讨重症监护病房（ICU）耐碳青霉烯酶鲍曼不动杆菌（CRAB）之间的同源性,并了解是否存在耐药菌株的克隆流行。方法收集宁波大学附属医院ICU 2010年2月至2011年5月分离到的CRAB 40株,常规药敏试验采用K-B法。用脉冲场凝胶电泳（PFGE）分析其耐药株的同源性。结果阿米卡星的敏感率最高为100%,其次米诺环素敏感率为50%;PFGE结果显示,40株CRAB菌株分为A、B、C三型,A型22株,主要分离时段为2010年2月～3月（16株）和2011年1月-2011年2月（6株）;B型16株,主要分离时段为2010年5月-6月（16株）,C型为C1亚型和C2亚型各1株为散发型。结论调查期间CRAB主要的PFGE基因型为A型和B型菌株克隆流行,流行相关的克隆株可在病区长期生存,从而引起病区持续感染,需要积极采取感染控制措施;同时不同时段主要流行株由克隆株A变为克隆株B,推测同一个病区的流行基因型可能存在流行变迁。

The homogeneity of carbapenem-resistant Acinetobacter baumannii in ICU

Objective To investigate the homogeneity and molecular epidemiology of carbapenem-resistant Acinetobacter baumannii(CRAB) from ICU.Method 40 strains of CRAB isolates were collected from 2010.2-2011.5 in ICU of our hospital.Susceptibility was tested by Kirby-Bauer(K-B) method.The homology of the resistant isolates was examined by pulse-field gel electrophoresis(PFGE).Result The sensitivity rate to amikacin was the highest,reaching up to 100%,followed by minocycline(50%);All of the 40 isolates belonged to three PFGE pulsotypes(A,B,C).There were 22 Pulsotype A isolates(16 isolated during February to March in 2010 and 6 during January to February in 2011),16 Pulsotype B isolates(during May to June in 2011),and 2 pulsotype C isolates(1 of subtype C1,1 of subtype C2).Conclusion The emergence of CRAB in the Affiliated Hospital of Ningbo University is associated with the spread of Acinetobacter baumannii strains of clone A and B.