广州市ICU环境中耐碳青霉烯类鲍曼不动杆菌的克隆相关性
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林云万

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R181.3+2

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广东省医学科研基金项目(A2015426);广东省医学科研基金项目(B2016007)


Clone correlation of carbapenemresistant Acinetobacter baumannii in environment of intensive care units in Guangzhou City
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    摘要:

    目的了解广州市重症监护病房(ICU)环境中耐碳青霉烯类鲍曼不动杆菌(CRAB)的克隆相关性,明确其基因分型,为预防和控制医院感染提供依据。方法收集广州市7所医院ICU环境中分离的39株CRAB,采用KB法测定其对10种抗菌药物的敏感性,采用聚合酶链反应(PCR)检测菌株的OXA基因,采用脉冲场凝胶电泳(PFGE)和多位点序列分型(MLST)对CRAB菌株进行克隆多态性分析。结果39株CRAB对左氧氟沙星耐药率最低,为56.4%,对其余9种抗菌药物耐药率均>90%。PCR扩增结果显示,39株(100%)CRAB均携带OXA51基因,37株(94.9%)携带OXA23基因,OXA24和OXA58基因未检出。PFGE技术显示,其中38株CRAB分为5个克隆群,A群为主要流行克隆;MLST分析结果显示,CRAB的主要流行克隆型为ST195。结论广州市ICU环境中存在携带OXA23基因的CRAB克隆传播,应加强ICU环境的清洁和消毒,减少由CRAB引起的医院感染。

    Abstract:

    ObjectiveTo understand the clone correlation of carbapenemresistant Acinetobacter baumannii (CRAB) in the environment of intensive care units(ICUs) in Guangzhou City, identify genotypes, and provide basis for prevention and control of healthcareassociated infection(HAI).Methods39 strains of CRAB isolated from environment of ICUs in 7 hospitals in Guangzhou City were collected, susceptibility to 10 kinds of antimicrobial agents was detected by KirbyBauer method, OXA gene of strains was detected by polymerase chain reaction (PCR), clone polymorphism analysis was performed with pulsedfield gel electrophoresis (PFGE) and multilocus sequence typing (MLST).ResultsAmong 39 strains of CRAB, resistance rate to levofloxacin was the lowest(56.4%), resistance rates to other 9 antimicrobial agents were all>90%. PCR results showed that 39 strains(100%) of CRAB all carried OXA51 gene, 37(94.9%) carried OXA23 gene, but OXA24 and OXA58 genes were not found. PFGE showed that 38 CRAB strains were divided into 5 clones, group A was the main epidemic clone, MLST analysis showed that the main clone of CRAB was ST195.ConclusionTransmission of CRAB clone carrying OXA23 gene exists in the ICU environment of Guangzhou City, cleaning and disinfection of ICU environment should be intensified, so as to reduce HAI caused by CRAB.

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林云万,周勇,张旭,等.广州市ICU环境中耐碳青霉烯类鲍曼不动杆菌的克隆相关性[J]. 中国感染控制杂志,2018,17(4):294-298. DOI:10.3969/j. issn.1671-9638.2018.04.004.
LIN Yunwan, ZHOU Yong, ZHANG Xu, et al. Clone correlation of carbapenemresistant Acinetobacter baumannii in environment of intensive care units in Guangzhou City[J]. Chin J Infect Control, 2018,17(4):294-298. DOI:10.3969/j. issn.1671-9638.2018.04.004.

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  • 收稿日期:2017-09-09
  • 最后修改日期:2017-11-10
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  • 在线发布日期: 2018-04-26
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