CAJ | 학술논문

目的：研究某院呼吸科重症监护室（RICU）鲍曼不动杆菌克隆传播特点及感染患者的临床特点，以指导临床有效防控鲍曼不动杆菌的传播。方法对40株分离自 RICU 住院患者的鲍曼不动杆菌进行脉冲场凝胶电泳（PFGE）同源性及聚类分析，比较并确定菌株间的亲缘关系，同时对其耐药性及临床资料进行分析。结果40株鲍曼不动杆菌分为 A～K 11种基因型，主要流行株为 A、B、E 型。耐药率最低的抗菌药物是亚胺培南（70．00％），其次是左氧氟沙星（77．50％）。40例感染者的平均年龄为67岁，平均住院时间41 d，12例感染者经治疗无效死亡。感染 A型及 E 型菌株患者在各自住院时间上均存在交叉；而感染 B 型菌株的患者，后6例与前6例并无住院时间上的交叉。结论该组 RICU 鲍曼不动杆菌感染流行株为 A、B、E 基因型，耐药率高；感染者平均年龄较高，住院时间长。合理应用抗菌药物，严格执行无菌操作，加强对医疗环境和医疗器械的消毒灭菌，对减少鲍曼不动杆菌的传播至关重要。
목적：연구모원호흡과중증감호실（RICU）포만불동간균극륭전파특점급감염환자적림상특점，이지도림상유효방공포만불동간균적전파。방법대40주분리자 RICU 주원환자적포만불동간균진행맥충장응효전영（PFGE）동원성급취류분석，비교병학정균주간적친연관계，동시대기내약성급림상자료진행분석。결과40주포만불동간균분위 A～K 11충기인형，주요류행주위 A、B、E 형。내약솔최저적항균약물시아알배남（70．00％），기차시좌양불사성（77．50％）。40례감염자적평균년령위67세，평균주원시간41 d，12례감염자경치료무효사망。감염 A형급 E 형균주환자재각자주원시간상균존재교차；이감염 B 형균주적환자，후6례여전6례병무주원시간상적교차。결론해조 RICU 포만불동간균감염류행주위 A、B、E 기인형，내약솔고；감염자평균년령교고，주원시간장。합리응용항균약물，엄격집행무균조작，가강대의료배경화의료기계적소독멸균，대감소포만불동간균적전파지관중요。
Objective To study transmission characteristics of Acinetobacter baumannii (A.baumannii )clone and clinical features of infected patients in a respiratory intensive care unit (RICU),so as to guide the effective pre-vention and control of A.baumannii transmission.Methods 40 A.baumannii strains isolated from RICU patients were performed homology analysis by pulsed-field gel electrophoresis (PFGE)and cluster analysis,relationship of strains was determined,antimicrobial resistance and clinical data were analyzed.Results 40 A.baumannii strains were divided into 11 genotypes(A-K),the main epidemic strains were type A,B and E.The resistant rate to imipen-em was the lowest(70.00%),the next was levofloxacin (77.50%).The average age of 40 infected patients was 67 years old,the average length of hospital stay was 41 days,12 patients died because of invalid treatment.There was overlapping hospitalization among patients infected with type A and E strains;among patients infected with type B strain,there was no overlapping hospitalization among the last 6 and first 6 infected patients.Conclusion The main epidemic strains of A.baumannii were type A,B and E,antimicrobial resistant rate is high;the infected patients are with high average age and long length of hospital stay.It is important to reduce the transmission of A.baumannii through rational use of antimicrobial agents,strict aseptic operation,and intensified disinfection and sterilization of hospital environment and medical devices.