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Burkholderia cepacia ST 767在血液透析病房引起了为期三年的医院疫情
Stéfani T A Dantas1, Gousilin R Silva1, Iranildo A Fernandes1
1Department of Genetic, Microbiology and Imunology, Institute of Biosciences, São Paulo State University, Botucatu, SP 18618-691, Brazil.
一个单一的Burkholderia cepacia菌株 (ST-767) 在血液透析单元的管道中持续存在三年,导致患者的血液感染. 生物膜形成和多药耐药性复杂治疗.
科学领域:
- 临床微生物学 临床微生物学
- 传染性疾病 传染性疾病
- 水中传播的病原体
背景情况:
- 血液透析患者因受污染的水或不当的透析器再处理而面临更高的血液感染风险.
- 在一个血液透析单位爆发的疫情促使对Burkholderia cepacia复合体 (Bcc) 的调查.
研究的目的:
- 确定血液透析患者和水中Bcc分离物的毒性因子.
- 在血液透析单位爆发期间确定BCC的流行病学数据.
- 在血液透析环境中调查BCC的持久性和特征.
主要方法:
- 分析了来自患者血液培养的33个Bcc分离物和来自水样的24个Bcc分离物 (2019-2022).
- 通过PCR评估病毒性基因 (cblA,esmR,zmpA,zmpB).
- 使用多位数序列类型 (MLST) 和脉冲场凝电泳 (PFGE) 进行特征化分离.
- 在20°C和35°C时评估生物膜的产生.
主要成果:
- 流行的是zmpB (100%) 和zmpA (96.5%) 的基因;cblA和esmR缺席.
- RecA测序确定B. cepacia (genomovar I) 是该物种.
- PFGE揭示了一个单一的脉冲型 (ST-767),既常见于人类,也常见于水中隔离物.
- 所有水分离子都显示在20°C时产生生物膜.
结论:
- 一个单一的Bcc菌株 (ST-767) 在血液透析单元的管道中持续了三年,尽管消毒.
- 在20°C的生物膜形成可能促进了菌株的持久性.
- 所有分离物体都表现出多药性耐药性,使患者的治疗复杂化.
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