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目的分析鲍曼不动杆菌的耐药监测以及rapd基因分型的意义,为合理用药及防控鲍曼不动杆菌院内感染提供参考依据。方法选择2014年5月-2016年4月间本院分离自住院患者不同标本的鲍曼不动杆菌620株(均为不重复菌株),采用全自动微生物分析仪(WalkAway-96SI)与纸片扩散法进行菌种鉴定及药敏试验,应用rapd技术对其中58株多重耐药鲍曼不动杆菌进行基因分型。结果 620株鲍曼不动杆菌耐药情况较重,其中对头孢哌酮/舒巴坦、左氧氟沙星耐药率分别为20.16%(125/620)和45.81%(284/620),对多粘菌素B均敏感;对其余13种抗菌药物耐药率均>56%。在620株菌株中多重耐药检出率为76.45%(474/620)。ICU与非ICU患者感染鲍曼不动杆菌对13种抗菌药物的耐药率(22.22%87.44和16.50%57.28%)比较差异统计学有意义(P<0.01);rapd技术分出8种类型基因:A-H,其中A型22株,B型12株,C型6株,D型8株,E型4株,F型3株,G型2株,H型1株。结论鲍曼不动杆菌的耐药情况较严重,呈逐年上升趋势,且存在多重耐药。rapd基因分型有助于细菌的同源性分析,可为防控院内感染提供依据。
Objective To analyze the drug resistance of Acinetobacter baumannii and the significance of rapd genotyping in order to provide reference for rational use of drug and prevention and cure of Acinetobacter baumannii infection in hospital. METHODS: From May 2014 to April 2016, 620 strains of Acinetobacter baumannii isolated from different hospitalized patients in our hospital were selected, all of which were non-repetitive strains. WalkAway-96SI and paper Diffusion method for strain identification and drug susceptibility testing, the application of rapd technology 58 strains of multi-drug resistant Acinetobacter baumannii genotyping. Results The results showed that 620 strains of Acinetobacter baumannii were resistant to cefoperazone / sulbactam and levofloxacin. The resistance rates to cefoperazone / sulbactam and levofloxacin were 20.16% (125/620) and 45.81% (284/620) B were sensitive; the remaining 13 kinds of antimicrobial resistance rates were> 56%. The detection rate of multidrug resistance in 620 strains was 76.45% (474/620). The rates of resistance to Acinetobacter baumannii in ICU and non-ICU patients (13.22%, 87.44 and 16.50%, 57.28%) were statistically significant (P <0.01). The rapd technique divided 8 types of genes : AH, of which 22 were type A, 12 were type B, 6 were type C, 8 were type D, 4 were type E, 3 were type F, 2 were type G and 1 was type H. Conclusion The Acinetobacter baumannii is more resistant, showing an increasing trend year by year, and has multiple drug resistance. rapd genotyping contribute to the homologous analysis of bacteria, which can provide the basis for prevention and control of nosocomial infection.