中国感染控制杂志2013，Vol.12Issue(3)：173-177,181,6.DOI:10.3969/j.issn.1671-9638.2013.03.004
耐碳青霉烯类鲍曼不动杆菌感染暴发的分子流行病学研究
Molecular epidemiologic characterization of infection outbreaks caused by carbapenem-resistant Acinetobacter baumannii
摘要
Abstract
Objective To investigate the epidemiologic characteristics and drug resistance mechanism of carbapenem-resistant Acinetobacter baumannii (CRAB) isolated from a hospital, so as to guide prevention and control of healthcare-associated infection(HAI). Methods A total of 32 CRAB strains isolated clinically from January 2010 to May 2012 were performed genotyping by randomly amplified polymorphic DNA fingerprinting, and epidemiological analysis was conducted; carbapenemase were screened by modified Hodge test and EDTA-disk synergy test. The effect of efflux pump inhibitor carbonyl cyanide m-chlorophenyl hydrazone (CCCP)on minimum inhibitory concentration of meropenem was detected, efflux pump positive strains were screened. Results 32 CRAB strains displayed 9 kinds of genotypes, type A, H, I,B, E, and other types were 10,7,4,3,3,and 1-2 isolates respectively. From March to May,2012, 11 CRAB strains were isolated, type H,I,and A were 7,3, and 1 isolates respectively. 21 (65. 63%) CRAB strains expressed oxacillinase (OXA-23), and were positive in modified Hodge test (including 11 strains isolated in March-May, 2012); Except 1 isolate was detected New Delhi-Metallo-1 (NDM-1), all other strains were negative for metallo-lactamase test; the presence of CCCP slightly changed the MIC of meropenem to CRAB,all were negative for phenotype of efflux pump. CRAB strains were mainly isolated from patients in intensive care unit(13 isolates) and neurology department(7 isolates). Conclusion The outbreak of HAI of the clone with identical genotype occurred in this ICU between March and May, 2012. Carbapenem-resistance mechanism of A. baumannii can be attributed to the expression of OXA-23, and meropenem-resistance is not related to the efflux pump, CRAB strain expressing NDM-\ has been detected in this hospital.关键词
耐碳青霉烯类鲍曼不动杆菌/鲍曼不动杆菌/耐药机制/医院感染/抗药性/微生物/多重耐药/分子流行病学Key words
carbapenem-resistant Acinetobacter baumannii/ Acinetobacter baumannii/ drug-resistance mechanism/ healthcare-associated infection/drug resistance, microbial/ multidrug resistance/ molecular epidemiology分类
医药卫生引用本文复制引用
孟小斌,张国雄..耐碳青霉烯类鲍曼不动杆菌感染暴发的分子流行病学研究[J].中国感染控制杂志,2013,12(3):173-177,181,6.基金项目
梅州市科技计划项目(2011B65) （2011B65）
