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目的对医护人员鼻腔中的鲍曼不动杆菌进行分离鉴定,对其来源和传播途径进行分析。方法用棉拭子采集10名医护人员和10名非医护人员(大学生)鼻腔样品,分离鉴定非重复鲍曼不动杆菌,采用K-B法检测其对13种常用抗生素的敏感性;利用多重PCR扩增OXA型碳青霉烯酶耐药基因;应用基因外重复回文序列REP-PCR对分离株进行分子多样性分析。结果共分离19株鲍曼不动杆菌,其中分离自医护人员鼻腔12株,分离自非医护人员鼻腔7株。K-B法检测Ab的耐药性,医护人员鼻腔分离株对环丙沙星(CIP)、亚胺硫霉素(IPM)、头孢曲松(CRO)、环磷酰胺(CTX)和新诺明(SXT)耐药率均≥41.7%,非医护人员分离株耐药率均≤3%;耐药基因检测19株菌中都携带OXA-51基因,且医护人员鼻腔分离株携带OXA-23菌株数多于非医护人员鼻腔分离株。另外两种未检出耐药基因(OXA-24和OXA-58)。REP-PCR显示,医护人员鼻腔分离株、非医护人员鼻腔分离株Ab的8种基因型(A-H)中同源性≥90%的有33株菌,占94.29%(33/35)。结论鲍曼不动杆菌不仅能通过直接接触传播,也可能存在气源性传播途径。
Objective To isolate and identify Acinetobacter baumannii in the nasal cavity of medical staff and analyze its source and transmission. Methods Nasal samples from 10 medical staff and 10 non-medical staff (undergraduates) were collected by cotton swab to separate and identify non-repetitive Acinetobacter baumannii. The susceptibility to 13 common antibiotics was detected by KB method. Add OXA type carbapenemase resistance gene; the use of extra-repetitive palindromic sequence REP-PCR molecular diversity analysis of the isolates. Results A total of 19 strains of Acinetobacter baumannii were isolated, of which 12 were isolated from the nasal cavity of medical staff and 7 were isolated from the nasal cavity of non-medical staff. KB method was used to detect the drug resistance of Ab and nasal isolates of ciprofloxacin (CIP), imipenem (IPM), ceftriaxone (CRO), cyclophosphamide (CTX) and cotrimoxazole SXT) resistant rates were all ≥41.7%, non-medical staff resistant rates were ≤3%; drug-resistant genes were detected in 19 strains of bacteria carrying OXA-51 gene, and medical staff nasal isolates carrying OXA-23 strains More than non-medical staff nasal isolates. The other two undetectable resistance genes (OXA-24 and OXA-58). REP-PCR showed that there were 33 strains with homology ≥90% in the eight genotypes (A-H) of nasal isolates from non-medical staff and non-medical staff nasal isolates, accounting for 94.29% (33/35). Conclusions Acinetobacter baumannii not only can be transmitted by direct contact, but also by airborne transmission.