| Objective:1. To study sample source and division distribution of strains of Acinetobacter baumannii isolated from hospitalized patients, and pollution source of hospital environmental samples.2. To study anti-drug of Acinetobacter baumannii on 12 kinds of antimicrobials, for providing evidence to clinical and reasonable treatment protocols.3. To understand gene type and the main epidemiological type, to analyze correlation between gene and anti-drug phenotype, and to study homology among Acinetobacter baumannii, making sure that Hospital Infections outbreak, investigating mechanism of transmission of anti-drug strains.4. contrastivly analyzing difference of drug-resistance and gene type between old and new endemic area, to study correlation between cross infection and hospital environment, and to illustrate importance of hospital environmental health.Methods:1. Collecting all 91 strains of Acinetobacter baumannii isolated from hospitalized patients; at the same, sampling from environment of old endemic area (Intensive Care Unit, Pneumology Department, integrated tcm-wm) and new endemic area (Intensive Care Unit, Pneumology Department, Integrated tcm-wm, Emergency ICU), to proceed common isolation and identification, in fine, collecting all 68 strains.2. takinge a sensitivity test on all collected Acinetobacter baumannii for 12 kinds of antimicrobial in Kirby-Bauer method.3. proceeding to analyze homology of gene type in ERIC-PCR methods.4. proceeding to statistics analysis on data in statistic software.5. compareing drug-resistance rate between old and new endemic area in chi square test methods.Results:1. Sample source and division distribution:91 strains isolated from hospitalized patients:mainly distribute in neurology department,department of neurosurgery,Pneumology Department and Intensive Care Unit. these divisions is 60.43% in all divisions of hospital; 78strains source from respiratory tract (sputum and bronchi primer) is 85.71%.68 trains isolated from hospital environmental samples:source from object surface widely, bed table (25strains) is 36.76% mainly; then, kinds of catheters (6æ ª)is 11.76%.2. Drug-resistance analysis:the drug-resistance rate of 159 strains to tigecycline, Imipenem, Meropenem, Cefoperazone/Sulbactam among 12 kinds of antimicrobials is 0%,27.04%,27.67%,13.21%, the rest is 35.22%～57.23%.The drug-resistance difference between old and new endemic area has stastic significance, expect Imipenem and Meropenem among 12 kinds of antimicrobials. Drug-resistance rate of strains isolated from hospital environmental samples is lower than strains isolated from hospitalized patients, no matter old or new endemic area. Drug-resistance rate of new endemic area is lower than old, no matter strains isolated from hospitalized patients or hospital environmental samples. Multidrug-resistance rate is 44.03% in our hospital, and new endemic area is lower old.3. Gene typing:1) 159 strains of Acinetobacter baumannii:were divided into 29 genetypes by ERIC-PCR, type A of them is 35.22%; 73 strains in old endemic area were divided into 19 genetypes, type A of them is 54.79%; 86 strains in new endemic area were divided into 23 genetypes, type A of them is 18.60%.2) Type A of strains isolated from hospitalized patients were distributed at neurology department,department of neurosurgery and Intensive Care Unit. Type A of strains from hospital environmental samples isolated mainly from a bed table of integrated tcm-wm,a return air port and monitor table top of emergency ICU in new endemic area, and Bedside,quilt,Nasal catheter,incision of tracheal tube and aspiration of sputum tube isolated from the old endemic area. Type A proportion of new endemic area is lower than the old, no matter strains isolated from hospitalized patients or hospital environmental samples. Type A proportion isolated from hospitalized patients is lower than from hospital environmental samples, no matter old or new endemic area. 3) Type A of strains were almost multidrug-resistance on drug-resistance spectrum.Conclusion:1. Department of neurosurgery, neurology department, Intensive Care Unit and pneumology department should prevent cross infection of Acinetobacter baumannii at hospital as important divisions. Bed table in ward of a hospital should be cleaned and sterilized.2. Acinetobacter baumannii is susceptible to the new antimicrobial-tigecycline, Imipenem, Meropenem, Cefoperazone/Sulbactam among 12 kinds of antimicrobials, most insensitive to the rest, and multidrug-resistance proportion is great, the drug-resistance rate of new endemic area than the old. Drug-resistance rate of strains isolated from hospital environmental samples is lower than strains isolated from hospitalized patients, no matter old or new endemic area. In short, it illustrates that cross infection and evironmental health of hospital have uniformity.3.159 strains of Acinetobacter baumannii in our hospital were divided into 29 genetypes, Type A strains were the main genetype, and them were divided into Department of neurosurgery, neurology department, Intensive Care Unit. Strains of Acinetobacter baumannii have homologous between strains isolated from hospitalized patients and hospital environmental samples. A identical clone strain is spreaded in a ward of hospital and among wards of hospital. Infection outbreaks in ICU of old endemic area and neurology department of new endemic area. mechanism of transmission of infection outbreak is that possiblely infection patients spread Acinetobacter baumannii to patients by contaminative tools and appliance.4. It has correlation between genetypes and drug-resistance spectrum.5. Type A of strains were almost multidrug-resistance on drug-resistance spectrum, displaying the diversity. Genetypes of new endemic area is most than the old's. Although the main genetype is type A between new and old endemic area, Type A proportion is lower, that is why drug-resistance rate and multidrug-resistance proportion are also lower. Type A proportion isolated from hospitalized patients is lower than from hospital environmental samples, no matter old or new endemic area. it illustrates that cross infection and evironmental health of hospital have uniformity.6. Depuratory and disinfection of object surface and hand health are important for preventing cross infection of Acinetobacter baumannii in hospital. |
