ICU病房耐碳青霉烯鲍曼不动杆菌的同源性分析

戚少云; 黄杰; 王璐; 黄新明

doi:10.13898/j.cnki.issn.1000-2200.2022.03.025

ICU病房耐碳青霉烯鲍曼不动杆菌的同源性分析

Homology analysis of carbapenem-resistant Acinetobacter baumannii in ICU

摘要

摘要:
目的了解某医院ICU病房耐碳青霉烯鲍曼不动杆菌（CRAB）耐药情况并分析其菌株同源性，为医院感染防控措施提供参考依据。
方法收集某医院ICU病房2017年4-10月分离的30株CRAB进行药敏试验，采用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）对其进行同源性分析。
结果30株CRAB对头孢替坦、头孢曲松、头孢他啶、头孢吡肟、环丙沙星耐药率为100.0%，对左氧氟沙星耐药率为73.3%。MALDI-TOF MS分析显示，30株CRAB分为三大簇：Ⅰ型（28株）、Ⅱ型（1株）和Ⅲ型（1株），其中Ⅰ型分为Ⅰa型（26株）、Ⅰb型（1株）、Ⅰc型（1株），2017年8月2-30日分离的Ⅰa型高达12株。
结论2017年4-10月，该院ICU病房分离的CRAB以Ⅰa型为主，其中8月份存在Ⅰa型CRAB感染病例聚集的趋向。

Abstract:
ObjectiveTo investigate the drug resistance of carbapenem-resistant Acinetobacter baumannii(CRAB) in ICU of a hospital, and analyze the homology of the strains, so as to provide reference for the prevention and control measures of nosocomial infection.
MethodsThirty CRAB strains isolated from ICU of a hospital from April to October 2017 were collected for drug sensitivity test, and their homology was analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS).
ResultsThe resistance rate of 30 CRAB strains to cefotetan, ceftriaxone, ceftazidime, cefepime and ciprofloxacin was 100.0%, and to levofloxacin was 73.3%.MALDI-TOF MS analysis showed that 30 CRAB strains were classified into three clusters, type Ⅰ(28 strains), type Ⅱ(1 strain) and type Ⅲ(1 strain), among which type Ⅰ was classified into type Ⅰa(26 strains), type Ⅰb(1 strain) and typeⅠc(1 strain), and 12 strains of type Ⅰa were isolated from August 2 to August 30 in 2017.
ConclusionsIn April to October 2017, the main type of CRAB isolated from ICU of a hospital is type Ⅰa, and there is a trend of aggregation of type Ⅰa CRAB infection cases in August.

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