开放性伤口分离阴沟肠杆菌的耐药性及多态性DNA分型研究
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摘要
目的了解地震后群体受伤患者开放性伤口分离阴沟肠杆菌的耐药性,并对其同源性进行研究,为群体外伤紧急医疗救治过程中是否存在医院感染提供科学依据。方法对汶川地震后14例开放性骨折或骨筋膜室综合症受伤患者的创面分离阴沟肠杆菌进行耐药性分型;同时留取菌株,采用随机扩增多态性DNA(RAPD)指纹图基因分型方法进行同源性分析。结果 6株阴沟肠杆菌的耐药性分型分为3型,RAPD分型分为4型,耐药谱分型相同的菌株RAPD分型不一定相同;同一患者上、下肢分泌物中分离的菌株同源性为100.0%;有5株菌株的同源性>90.0%,菌株间的差异非常小,可能存在耐药菌株的相互传播。结论群体受伤患者伤口感染细菌耐药性强,且伤口感染的同源性较高,存在医院感染的可能;因此,在突发灾难救援工作中,应重视医院感染控制工作,避免耐药细菌的传播和流行。
OBJECTIVE To understand the drug resistant status and homogeneity of Enterobacter cloacae which were extracted from secretion,and to make scientific judgment about nosocomial infections.METHODS Bedside sampling was performed for 14 patients,who get compound fracture or osteofascial compartment syndrome after Wenchuan earthquake.The samples were subjected for bacterial,fungus and anaerobic culture,and then antimicrobial susceptibility test(AST) was selected according to pathogens.RAPD test were performed for analyzing homology.RESULTS Drug resistance type of E.cloacae and RAPD typing results were as follows: 6 strains of E.cloacae resistant type was divided into 3 types by drug resistance spectrum,and RAPD type divided them into 4 types.From the same patients,the lower extremity strains homology was 100.0%.Five strains showed more than 90.0% homology,with little differences between those strains,the dissemination between the resistant strains might be existed.CONCLUSION High homology of wound infection in the earthquake victims suggests there is the possibility of cross-infection.In case of sudden disaster relief work,attention should be paid to the hospital infection control to avoid the spread and prevalence of resistant bacteria.
OBJECTIVE To understand the drug resistant status and homogeneity of Enterobacter cloacae which were extracted from secretion,and to make scientific judgment about nosocomial infections.METHODS Bedside sampling was performed for 14 patients,who get compound fracture or osteofascial compartment syndrome after Wenchuan earthquake.The samples were subjected for bacterial,fungus and anaerobic culture,and then antimicrobial susceptibility test(AST) was selected according to pathogens.RAPD test were performed for analyzing homology.RESULTS Drug resistance type of E.cloacae and RAPD typing results were as follows: 6 strains of E.cloacae resistant type was divided into 3 types by drug resistance spectrum,and RAPD type divided them into 4 types.From the same patients,the lower extremity strains homology was 100.0%.Five strains showed more than 90.0% homology,with little differences between those strains,the dissemination between the resistant strains might be existed.CONCLUSION High homology of wound infection in the earthquake victims suggests there is the possibility of cross-infection.In case of sudden disaster relief work,attention should be paid to the hospital infection control to avoid the spread and prevalence of resistant bacteria.
引文
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[2]董玉梅,靳桂明,吴江平,等.地震创伤性感染病原菌状况分析[J].中华医院感染学杂志,2009;19(13):1757-1759.
[3]李争鸣,谭亮,刘晓玲.革兰阴性杆菌产AmpC酶诱因分析及监测[J].现代生物医学进展,2007,7(8):1190-1192.
[4]黄和赞,张国强,张文庆,等.阴沟肠杆菌耐药性及氨基糖苷类修饰酶基因研究[J].中华医院感染学杂志,2009,19(19):2529-2531.
[5]张永利,顾怡明,张杰,等.多重耐药阴沟肠杆菌β-内酰胺酶编码基因的研究[J].中华医院感染学杂志,2004,14(5):481-484.
[6]管婧,李红玉,卓超,等.耐甲氧西林金黄色葡萄球菌耐药性及基因型分析[J].中华医院感染学杂志,2011;21(2):211-214.
[7]桂炳东,王伶,邹叶青,等.高产AmpC酶阴沟肠杆菌的耐药性及同源性分析[J].中华医院感染学杂志,2005,15(12):1332-1334.
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