【摘要】 目的对某医院中心重症监护病房(ICU)2007年1月-2009年7月3次疑似多药耐药鲍氏不动杆菌(MDRAB)医院流行时间段内的MDRAB进行同源性分析。方法收集ICU住院患者标本中分离的28株MDRAB,以及从该病房环境中分离的7株ABA;运用脉冲场凝胶电泳分析菌株的同源性。结果脉冲场凝胶电泳结果表明,36株菌有4个克隆,其中克隆A包括临床分离株648,3个环境分离株B8、J4、C9;B型、C型全为临床分离株,分别包括1196、1201、1103、1205、1150和3325、3693、3334、3893、4006、4128、4358、3605;D型包括3次临床分离株433、438、458及一个环境分离株(B15)。结论 3次医院流行分别由克隆D、B、C引起,患者间MDRAB的交叉传播是医院流行的主要传播方式,环境样品分离鉴定及同源性分析结果提示,ICU的通风系统是MDRAB流行的源头;严格的消毒、隔离措施,强调手卫生,能有效控制MDRAB的医院流行。更多还原

【Abstract】 OBJECTIVE To investigate the homogeneity and molecular epidemiology of multidrug-resistant Acinetobacter baumannii(MDRAB) from intensive care unit(ICU) during suspected three MDRAB nosocomial epidemic times.METHODS Totally 29 MDRAB strains isolated from patients and 7 AB strains isolated from the environment were collected.Pulsed Field Gel Electrophoresis was performed to analyze the genetic relatedness.RESULTS Cluster analysis revealed that 36 isolates belonged to four clones.Clone A included 648 clinical isolate and three environmental isolates(B8,J4,C9);clone B included five clinical isolates(1196,1201,1103,1205 and 1150),clone C included eight clinical isolates(3325,3693,3334,3893,4006,4128,4358 and 3605),clone D included three clinical isolates(433,438 and 458) and one environmental isolates(B15).CONCLUSIONS Three nosocomial epidemics are caused by clone D,B,C.Cross-transmission between patients is the main mode of transmission of nosocomial epidemic.Isolation and identification in environmental samples and homology analysis reveal that the ventilation system of ICU ward may be a source of MDRAB.Strict disinfection and isolation measures,emphasizing hand hygiene can effectively control the epidemic of MDRAB in hospital.更多还原