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目的调查鲍氏不动杆菌引起的医院感染暴发的可能来源及其qacE△1-sulⅠ基因的携带情况,并采取有效控制措施。方法对江苏某医院ICU 2016年6月6日-26日分离到的不动杆菌属细菌30株进行鉴定、药敏分析、脉冲场凝胶电泳(PFGE)分型及qacE△1-sulⅠ基因检测。结果从30株不动杆菌属细菌中检测出鲍氏不动杆菌27株(8株患者菌株、19株物体表面菌株),药敏结果显示,8株患者菌株除对左氧氟沙星耐药率较低(12.5%)外,对其他受检抗菌药物均处高水平耐药(>80.0%);物体表面表菌株除对左氧氟沙星(10.5%)、亚胺培南(52.6%)耐药率相对较低外,对其他抗菌药物的耐药率均>68.0%;PFGE基因分型显示同源菌株主要分为两型,其中一型包括3株患者菌株,另一型包括4株患者菌株和11株物体表面菌株;qacE△1-sulⅠ基因检测显示7株患者菌株和13株物体表面菌株检测结果阳性,χ2检验结果显示,阳性菌株在患者和物体表面的分布有显著差异,受检抗菌药物的耐药性关联性分析显示,该基因和大多数的抗菌药物耐药有关联。结论本研究运用PFGE技术发现鲍氏不动杆菌在该院ICU患者间及ICU环境中的播散,且大多数细菌均携带qacE△1-sulⅠ基因,该基因与大多受检抗菌药物的耐药有关,医院应加强消毒措施的管理和执行以避免感染再次暴发。
Objective To investigate the possible sources of outbreaks of nosocomial infection caused by Acinetobacter baumannii and the carrying status of qacE △ 1-sulⅠ gene and take effective control measures. Methods Thirty strains of Acinetobacter isolated from ICU of a hospital in Jiangsu Province from June 6 to June 26, 2016 were identified. Drug susceptibility analysis, PFGE typing and qacE △ 1-sul I gene detection . Results 27 strains of Acinetobacter baumannii were isolated from 30 strains of Acinetobacter (8 strains of patients and 19 strains of strains). The results of drug susceptibility showed that the strains of 8 strains except low resistant rate to levofloxacin 12.5%), the drug resistance of other tested antimicrobial agents was high (> 80.0%). The strains on the surface of the target surface were relatively low resistant to levofloxacin (10.5%) and imipenem (52.6%) , And the resistance rate to other antibiotics was> 68.0%. PFGE genotyping showed that the homologous strains were divided into two types, one type including 3 strains of patients and the other type including 4 strains of patients and 11 objects The results of qacE △ 1-sulI gene test showed that the positive strains were positive in 7 strains and 13 strains. The χ2 test showed that the distribution of positive strains on the surface of patients and objects were significantly different. The antibacterial resistance Correlation analysis revealed that the gene was associated with most antimicrobial resistance. Conclusion In this study, PFGE was used to detect Acinetobacter baumannii in the hospital ICU patients and ICU environment dissemination, and most of the bacteria are carrying qacE △ 1-sul Ⅰ gene, the gene and most of the tested antimicrobial resistance Relevant, the hospital should strengthen the management and implementation of disinfection measures to prevent the recurrence of an outbreak of infection.