多重耐药鲍曼不动杆菌同源性分析

目的研究台州医院中心重症监护病房（ICU）及脑外重症监护病房（SICU）2006年1月出现的多重耐药鲍曼不动杆菌（MDR-AB）的耐药性、碳青霉烯酶基因型及同源性。方法运用VITEK-60全自动微生物仪对分离自2006年1月ICU和SICU患者多重耐药鲍曼不动杆菌8株进行菌种的重新鉴定，采用微量板稀释法测定β-内酰胺类、氨基糖苷类、氟喹喏酮类等17种抗菌药物的体外最低抑菌浓度（MIC）（其中头孢哌酮／舒巴坦、美洛配能采用K-B法测定耐药性）。采用PCR对8株菌株进行OXA型碳青霉烯酶基因型检测，运用脉冲场凝胶电泳分析菌株的同源性。结果8株菌株仅对头孢哌酮／舒巴坦敏感，对头孢菌素类、氨基糖苷类、氟喹喏酮类和碳青霉烯类等抗菌药物均显示出较高水平的耐药；8株菌株均产OXA-23型碳青霉烯酶；脉冲场凝胶电泳证实其为同一克隆。结论本组鲍曼不动杆菌为多重耐药株，同一克隆株在不同感染个体的相互传播，导致了这次院内感染的流行。

Homogeneous analysis of epidemic strains of multidrug-resistant Acinetobacter baumannii

Objective To investigate the drug resistance,the homology and the earbapenemases gene type of the multi-drug resistant Aeinetobaeter baumanii（MDR-AB） strains isolated from inpatients in ICU and SICU of our hospital during January 2006. Methods VITEK-60 system was used to identify 8 MDS-AB strains isolated from inpatients at ICU and SICU during January 2006. Then antibiotics, such as eephalosporins, aminoglyeosides, quinolones and earbopenems, were applied to test the 8 strains＇ susceptibility with VITEK-60 system except for cefoperazone/sulbactam and meropenem that were experimented by K-B method. PCR was carried out to amplify the carbapenemase genes and identify the DNA typing of the 8 strains. Results The 8 strains were sensitive to cefoperazone/sulbactam and expressed highly resistant to cephalosporins, aminoglycosides,quinolones and carbopenems. The 8 strains came from the same gene typing：that was OXA-23. PFGE con- firmed the 8 strains were the same one clone. Conclusion One clone of MDR-AB had led to partly prevalence in our hospital. The carbapenemase genotype of this strains is OXA-23.