论文部分内容阅读
目的分析某综合医院重症监护病房(ICU)多药耐药鲍曼不动杆菌(MDR-AB)医院感染病例与医疗环境的相关性,了解ICU临床分离株与环境分离株MDR-AB的同源性。方法收集2014年2—8月某综合医院神经外科ICU、胸腔外科ICU和综合ICU住院患者分离出的多重耐药鲍曼不动杆菌临床标本,同时采集患者周围环境及医护人员标本,采用脉冲场凝胶电泳(PFGE)法对临床及环境标本进行同源性分析。结果 51株临床株分离自下呼吸道分泌物26株,随后依次为脑脊液、血液、腹腔引流液各3株,尿液、分泌物各2株,另2株分别是导管和胸水。临床与医疗环境分离的64株MDR-AB,PFGE分为6型2个亚型,其中A型是主要流行株,与B型、C型在神经外科ICU与综合ICU引起流行,并存在交叉感染。ICU环境中分离多药耐药鲍曼不动杆菌15株,主要分离自墨菲式滴管、血压计袖带、护理桌、床护栏等;A、B、C、D、E、F型分别为4株(26.7%)、2株(13.3%)、4株(26.7%)、3株(20.0%)、1株(6.7%)和1株(6.7%)。结论多药耐药鲍曼不动杆菌患者周围环境经常受到污染,MDR-AB在该院部分ICU之间存在交叉感染,MDR-AB感染临床分离株与环境株有较高的相关性。接触传播可能是MDR-AB的医院内感染重要途径。
Objective To analyze the correlation between MDR-AB hospital infection and medical environment in ICU intensive care unit (ICU) and to find out the homology of ICU clinical isolates and environmental isolates MDR-AB Sex. Methods The clinical specimens of multidrug-resistant Acinetobacter baumannii isolated from the neurosurgery ICU, thoracic surgical ICU and integrated ICU inpatients in a general hospital from February to August 2014 were collected. At the same time, samples of patients’ surroundings and medical staffs were collected. The pulse field Gel electrophoresis (PFGE) method for clinical and environmental specimens homology analysis. Results Totally 26 strains of lower respiratory tract secretions were obtained from 51 clinical isolates, followed by 3 cerebrospinal fluid (CSF), blood and peritoneal drainage fluids (2) and 2 urine and secretions (2 catheters and pleural effusion respectively). Sixty-four MDR-AB and PFGE isolated from clinical and medical environments were divided into six subtypes of type 6, of which type A was the major epidemic strain, with type B and type C causing epidemics in the neurosurgical ICU and integrated ICU with cross-infection . Fifteen strains of Acinetobacter baumannii isolated from ICU were isolated from Murphy’s dropper, sphygmomanometer cuff, nursing table and bed guardrail. A, B, C, D, E and F There were 4 strains (26.7%), 2 strains (13.3%), 4 strains (26.7%), 3 strains (20.0%), 1 strain (6.7%) and 1 strain (6.7%). Conclusions The environment of multidrug-resistant Acinetobacter baumannii is often contaminated. MDR-AB is cross-infected in some ICU of the hospital. The clinical isolates of MDR-AB infection are highly correlated with environmental strains. Contact transmission may be an important route of nosocomial infection of MDR-AB.