| Objective:1.To observe the clinical distribution and drug resistance of Pseudomonas aeruginosa isolated from various specimens in the Clinical Laboratory of the First Affiliated Hospital of Guangxi Medical University from December 2013 to April 2014.2.To understand the genetic relationship between Pseudomonas aeruginosa strains in our hospital.3.The RAPD type of Pseudomonas aeruginosa was compared to determine the presence of local outbreaks.4.To investigate the genotype variation of Pseudomonas aeruginosa isolated from inpatients with long-term and continuous infection in various clinical departments of hospital.Methods:1.Collect all the strains of Pseudomonas aeruginosa that isolated from sputum,blood,urine,wound secretions and other types of specimens in the bacterial Laboratory of the First Affiliated Hospital of Guangxi Medical University during December 2013 to April 2014,and the related informationswere also collected.Based on the standards established by the American Society for clinical and laboratory standards(CLSI)in 2012 and national clinical laboratory procedures.The identification and drug sensitivity analysis of the collected samples were performed by using VITEK-2 automatic bacterial identification and drug sensitivity classification system and ATB expression semi-automatic bacterial identification instrument.Eliminate the same strains that isolated from the same patient and the same site,then the source distribution and drug sensitivity were analyzed.2.Selection of strains of Pseudomonas aeruginosa isolated from patients which the infection lasted for more than 30 days,extraction of bacteria DNA by boiling method,obtained the RAPD fingerprinting by random amplified polymorphic DNA(RAPD)genotyping technique,analyzed homology by homology clustering,and understood the genetic relationship between Pseudomonas aeruginosa through the similarity coefficient.At the same time,we compared the RAPD type to determine whether there was an epidemic outbreak and whether there was a variation between the strains from the same patient with continuous infection.Results:1.A total of 293 strains of Pseudomonas aeruginosa were collected,including 175 strains of non-repetitive Pseudomonas aeruginosa which isolated from different patient and different site.From the specimen source,the majority of the strains were isolated from sputum and bronchoalveolar lavage fluid,accounting for 52%(91/175),followed by the rest of the wound secretions accounted for 18.9%(33/175),urine accounted for 6.9%(12/175),blood accounted for 6.3%(11/175),liquid drainage accounted for 5.7%(10/175),the rest were from indwelling catheter,throat swab specimens,and so on.From the distribution of departments,non repetitive Pseudomonas aeruginosa mainly fromthe intensive care unit 25.7%(45/175),followed by the department of burn and plastic surgery 17.7%(31/175),department of traditional Chinese medicine13.1%(23/175),department of respiratory medicine accounted for8.6%(15/175),pediatric accounted for 5.1%(9/175),the other specimens were from other wards.Analysis of the drug resistance,we found that the resistance rates of non-repetitive Pseudomonas aeruginosa to ciprofloxacin,levofloxacin,aztreonam and gentamicin,tobramycin were greater than 30%.2.A total of293 strains of Pseudomonas aeruginosa were collected,including 117 srains in which the infection duration was longer than 30 days,and then 19 genotypes were amplified with A-S type,and the classification rate is 100%.In the intensive care unit and the department of burn and plastic surgery,the same RAPD type was detected in different patients,the rest of the patients had different RAPD types.The fingerprints of Pseudomonas aeruginosa that isolated from the sputum,wound secretions,blood,urine and other specimens of 4 cases of patients who suffered chronic infection changed,the other fingerprints of Pseudomonas aeruginosa that isolated from other 19 cases of patients did not changed.Conclusions:1.The infection of Pseudomonas aeruginosa mainly occurred in the intensive care unit,the department of burn and plastic surgeryand department of traditional Chinese medicine;they showed different degrees of resistance to multiple antibiotics,we found that the resistance rates of Pseudomonas aeruginosa to ciprofloxacin,levofloxacin,aztreonam and gentamicin,tobramycin were greater than 30%,and the resistance to polymyxin B was 0,the sensitive rate 100%.2.There is a high degree of homology between some types.3.The epidemic outbreak of P.a occurred in the intensive care unit and the department of burn and plastic surgery.4.Pseudomonas aeruginosa RAPD genotype may change during the course of chronic infection. |
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