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目的调查福建省某综合性医院各临床科室多重耐药鲍曼不动杆菌(MDR-AB)的流行情况以及耐药性与基因型别之间的关联,为临床预防及治疗提供指导。方法随机收集MDR-AB 286株,采用K-B法进行药敏试验,脉冲场凝胶电泳(PFGE)进行基因分型并对结果进行聚类分析。结果 286株MDR-AB按90%相似度可分为43种基因群,其中G23、G25为优势基因群,且2009年-2012年中均有检出,流行科室以外科片区为主,综合ICU为高发科室;结合药敏结果,各基因群除头孢哌酮/舒巴坦和米诺环素的耐药率低于40%外,其余耐药率均大于65%,且G23群的耐药比例最高,对碳青霉烯类的耐药率与G25群相比较,分布差异有统计学意义。结论控制MDR-AB菌株的流行应加强对优势克隆群的监测,合理使用抗菌药物,加强高发及流行科室的消毒灭菌工作及人员管理。
Objective To investigate the prevalence of multidrug-resistant Acinetobacter baumannii (MDR-AB) and the relationship between drug resistance and genotypes in clinical departments of a general hospital in Fujian province and provide guidance for clinical prevention and treatment. Methods A total of 286 MDR-AB strains were collected. Susceptibility test was performed by K-B method and genotyping was performed by pulsed-field gel electrophoresis (PFGE). The results were clustered. Results 286 strains of MDR-AB were classified into 43 gene clusters according to 90% similarity. Among them, G23 and G25 were the dominant gene groups, and were detected in 2009 to 2012. The epidemiological departments mainly focused on the surgical area and the integrated ICU As the high-risk department; combined with drug susceptibility results, the drug resistance rates of all gene groups except cefoperazone / sulbactam and minocycline were less than 40%, and the remaining drug resistance rates were more than 65%, and the drug resistance of G23 group The highest proportion of carbapenem resistance rates compared with the G25 group, the distribution was statistically significant. Conclusion The control of the prevalence of MDR-AB strains should strengthen the monitoring of the dominant clonal population, rational use of antimicrobial agents, and strengthen the disinfection and sterilization of high incidence and epidemic departments and personnel management.