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目的用低频限制性位点聚合酶链反应(IRS-PCR)对鲍曼不动杆菌进行基因分型,分析基因型与鲍曼不动杆菌耐药谱的关系,并初步探讨其在分子流行病学中的作用。方法随机收集2008年8月至2009年8月临床分离的73株鲍曼不动杆菌,采用K-B法进行药物敏感试验确定鲍曼不动杆菌耐药谱;同时利用IRS-PCR对此73株鲍曼不动杆菌进行基因分型;并分析IRS-PCR分型与鲍曼不动耐药谱的关系;结合IRS-PCR分型结果与73株鲍曼不动杆菌感染病例的临床资料,分析在此时间段鲍曼不动杆菌在我院流行感染的情况。结果药物敏感试验将73株鲍曼不动杆菌菌株分为A1(19株全耐药型)和A2～A31(54株耐药谱型)31个药敏谱。IRS-PCR法将其分为A～W共23个基因型,其中A、C、B、D和E型为5种优势菌株,分别为14、11、10、8和6株。对比研究发现A1型菌株(15/19)主要集中在基因型A、C、D内,而基因型B包含A15型耐药菌株9株(69.2%),基因型E包含A3型耐药菌株3株(42.9%)。A基因型在院内特别是ICU中心引起2次爆发流行,而C和D型主要在呼吸内科引起感染。结论 IRS-PCR基因分型与药敏分型有较高的一致性,且IRS-PCR基因分型在早期发现和预防感染暴发流行方面优于药敏分型。
Objective To genotype Acinetobacter baumannii by low frequency restriction site-directed polymerase chain reaction (IRS-PCR) and to analyze the relationship between genotypes and drug resistance spectrum of Acinetobacter baumannii and preliminary study on its relationship with molecular epidemiology The role of learning. Methods 73 strains of Acinetobacter baumannii isolated clinically from August 2008 to August 2009 were randomly collected. The antibiotic resistance spectrum of Acinetobacter baumannii was determined by KB method. Meanwhile, IRS- The genotypes of Acinetobacter baumannii were analyzed. The relationship between IRS-PCR typing and Baumann’s immobility spectrum was analyzed. The clinical data of 73 cases of Acinetobacter baumannii infection were analyzed by IRS- Acinetobacter baumannii epidemic infection in our hospital during this time. Results Drug susceptibility test The 73 strains of Acinetobacter baumannii were divided into 31 drug susceptibility profiles of A1 (19 fully resistant) and A2 ~ A31 (54 resistant). IRS-PCR method was divided into A ~ W total of 23 genotypes, among which, A, C, B, D and E were the five dominant strains, which were 14, 11, 10, 8 and 6 strains respectively. The comparative study found that type A1 strains (15/19) mainly concentrated in genotypes A, C and D, while genotype B contained 9 strains (69.2%) of type A15 resistant strains and genotype E contained type A3 resistant strains Strain (42.9%). The A genotype caused two outbreaks in the hospital, especially in the ICU center, whereas C and D infections were mainly caused by respiratory medicine. Conclusion The genotyping of IRS-PCR is highly consistent with drug-sensitive typing, and genotyping by IRS-PCR is superior to drug-susceptible typing in the early detection and prevention of outbreaks of infection.