中华皮肤科杂志

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重症监护和肝移植病房环境及高危人群曲霉监测和分析

敖俊红1, 杨燕妮2, 周村建1, 钟白玉1, 李芹阶1, 郝飞1   

  1. 1. 第三军医大学西南医院皮肤科 重庆 400038;
    2. 第三军医大学护理系基础护理教研室
  • 收稿日期:2007-01-15 出版日期:2007-08-15 发布日期:2007-08-15
  • 通讯作者: 郝飞,email:haofei@mail.tmmu.com.cn E-mail:haofei@mail.tmmu.com.cn

The surveillance and molecular epidemiology of Aspergillus in the environment and patients at liver transplant department and intensive care units

AO Jun-hong1, YANG Yan-ni2, ZHOU Cun-jian1, ZHONG Bai-yu1, LI Qin-jie1, HAO Fei1   

  1. Department of Dermatology, Southwest Hospital of Third Military Medical University, Chongqing 400038, China
  • Received:2007-01-15 Online:2007-08-15 Published:2007-08-15

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摘要： 目的 探讨侵袭性曲霉病与医院环境曲霉污染是否有关。方法 对西南医院肝移植病房、脑外科ICU病房和中心ICU病房环境及高危患者鼻腔、咽部和痰液标本进行监测培养.采用随机扩增多态性DNA分析方法对分离自环境和患者体内的黄曲霉进行基因分型研究。结果 肝移植病房、脑外科ICU病房、中心ICU病房空气曲霉密度分别12、10.75cfu/m3和0。医院环境中5种常见的曲霉依次为黄曲霉、烟曲霉、黑曲霉、杂色曲霉和棒曲霉。RAPD分析显示,脑外科ICU2例患者体内分离的黄曲霉与病房环境分离的黄曲霉基因型相同;中心ICU病房3例患者体内分离的黄曲霉与病房环境分离的黄曲霉基因型均不相同,但2例患者体内分离的黄曲霉基因型相同。结论 肝移植病房、脑外科ICU病房和中心ICU病房存在不同程度曲霉污染,脑外科ICU2例患者体内分离的黄曲霉和环境中分离的黄曲霉基因型相同。

关键词: 曲霉菌属, 曲霉菌病, 环境污染, 重症监护病房

Abstract: Objective To explore the possible relationship between environmental contamination by Aspergillus and invasive aspergillosis.Methods From November 2005 to October 2006,samples were collected from the environment (air in corridors,air in wards,surfaces and tap water) twice a month,and from patients (nose,pharynx and sputum) at a liver transplantation department (LTD),neurologic surgery intensive care unit (NSICU) and central intensive care unit (CICU) in our hospital,and subjected to fungal culture.The Aspergillus density was determined in these environments.The isolates of Aspergillus flavus were genotyped by random amplification of polymorphic DNA (RAPD) assay to investigate the origin of infection.Results The mean aspergillus density was 12,10.75,0 and 20 cfu/m3 at LTD,NSICU,CICU and corridors respectively.The five most prevalent species of aspergillus in these environments in decreasing order were Aspergillus flavus,Aspergillus fumigatus,Aspergillus niger,Aspergillus versicolor and Aspergillus clavatus.RAPD demonstrated that the genotypes ofA.flavus isolated from two patients were identical to those of the environmental strains in NSICU.The A.flavus genotypes from 3 patients in CICU were all different from those of the environment strains in CICU,but the genotypes were identical from two of the three patients.Conclusions Aspergillus contamination of different degree does exist at LTD,NSICU and CICU. The genotypes of A.flavus are identical from patients and environment in NSICU,suggesting that the clinical infection may originate from hospital environment.

Key words: Aspergillus, Aspergillosis, Environmental pollution, Intensive care units