應用腸桿菌科基因間重復序列聚合酶鏈反應對鮑曼不動桿菌進行同源性分析

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應用腸桿菌科基因間重復序列聚合酶鏈反應對鮑曼不動桿菌進行同源性分析

聞海豐1秦瑾2于文靜3馮彥蕊1馮忠軍1★

［摘要］目的了解臨床不同來源的鮑曼不動桿菌是否存在同源性，判斷其是否存在耐藥菌株的克隆播散，追蹤其在醫院交叉感染的可能途徑，以便有效防控鮑曼不動桿菌在醫院中傳播。方法收集2012年10月至2013年6月臨床分離的73株多重耐藥鮑曼不動桿菌，用腸桿菌科基因間重復序列-聚合酶鏈反應（enterobacterial repetitive intergenic consensus-polymerase chain reaction，ERIC-PCR）對菌株進行同源性分析。結果73株多重耐藥鮑曼不動桿菌經ERIC-PCR分型分為8個基因型，分別用A、B、C、D、E、F、G、H表示，其中A型31株，B型15株，C型12株，D型8株，E型3株，F型2株，G和H型各為1株。A型為主要的流行株，分布在多個不同的科室。重癥監護室（intensive care unit，ICU）分離的菌株存在6個基因型；骨科系統病區存在4個基因型；急診科有5個基因型；內科發現有6個基因型；外科發現3個基因型。ICU病房環境物體表面共分離出4株鮑曼不動桿菌，其中9號和10號菌株來自于不同患者的床旁，12號和13號來自于護理站電腦鍵盤。結論臨床分離的多重耐藥鮑曼不動桿菌存在多個基因型。多重耐藥鮑曼不動桿菌存在時間和空間的聚集性。

［關鍵詞］鮑曼不動桿菌；多重耐藥性；腸桿菌科基因間重復序列-聚合酶鏈反應；同源性

作者單位：1．河北醫科大學第三醫院檢驗科，河北，石家莊050051 2．河北醫科大學第三醫院感控科，河北，石家莊050051 3．河北省兒童醫院檢驗科，河北，石家莊050031

Study on the homology of Acinetobacter baumannii by enterobacterial repetitive intergenic consensuspolymerase chain reaction

WEN Haifeng1, QIN Jin2, YU Wenjing3, FENG Yanrui1, FENG Zhongjun1★
(1. Department of Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China, 050051; 2. Department of Noscomical Infection Control, The Third Hospital of Hebei Medical University, Hebei, China, 050051; 3. Department of Laboratory Medicine, Chindren's Hospital of Hebei Procince, Hebei, China, 05005)

[ABSTRACT] Objective To investigate the homology of clinical isolated Acinetobacter baumannii and the epidemiology of the possible transmission routes.Methods73 isolates of non-repetitive multidrug resistant Acinetobacter baumannii were collected from October 2012 to June 2013. Epidemiological typing was performed by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR).Results The 73 isolates of Acinetobacter baumannii were classified into 8 distinct patterns by ERIC-PCR, including 31 of genotype A, 15 of genotype B, 12 of genotype C, 8 of genotype D, 3 of genotype E, 2 of genotype F, 1 of genotype G, and 1 of genotype H. Genotype A was the dominating clone and distributed in different wards. There were 6 genotypes in ICU unit, 4 genotypes in the department of orthopedics, 5 genotypes in emergency department, 6 genotypes in internal medicine and 3 genotypes in surgical department, respectively. There were 4 isolates of Acinetobacter baumannii on the surface of ICU unit. No. 9 and No. 10 isolates wereisolated from the bedsides of different patients, and No. 12 and No. 13 were isolated from the computer keyboard in nurses' station.ConclusionThe isolates of Acinetobacter baumannnii in our hospital have multiple genotypes. There were temporal and spatial aggregations in the infection of Acinetobacter baumannnii in our hospital.

[KEY WORDS] Acinetobacter baumannii; Multidrug resistant; ERIC-PCR; Homology

鮑曼不動桿菌（Acinetobacter baumannii，ABA）是一種非發酵革蘭陰性球桿菌，具有較強的耐干燥能力，極易形成生物膜，可在醫院環境中長期存活。……