多重耐药革兰阴性杆菌耐消毒剂基因qacE△1-sul1监测

Surveillance on disinfectant-resistant gene qacE△1-sul1 in multidrug-resistant gram-negative bacilli

目的了解某院临床常见革兰阴性(G^-)杆菌多重耐药株耐消毒剂基因qacE△1-sul1的产生情况。方法收集临床分离的G^-杆菌235株,包括155株多重耐药株和80株敏感株,采用聚合酶链反应(PCR)法检测qacE△1-sul1基因,并进行DNA测序。结果在50株产超广谱β-内酰胺酶(ESBLs)大肠埃希菌、27株产ESBLs肺炎克雷伯菌、50株多重耐药的铜绿假单胞菌和28株多重耐药的鲍曼不动杆菌中,检出qacE△1-sul1株分别为37、24、46、28株,检出率分别为74.00%、88.89%、92.00%和100.00%,总的检出率为87.10%;在非产ESBLs的大肠埃希菌、肺炎克雷伯菌以及铜绿假单胞菌和鲍曼不动杆菌的敏感株(各20株)中,分别检出qacE△1-sul1株16、7、5、13株,检出率分别为80.00%、35.00%、25.00%和65.00%,总的检出率为51.25%。结论该院G^-杆菌多重耐药株耐消毒剂基因qacE△1-sul1的携带率较高,加强多重耐药菌对消毒剂耐药性的监测,对临床合理使用消毒剂具有重要意义。

Objective To investigate the disinfectant-resistant gene qacE△1-sul1 in clinical multidrug-resistant （MDR） gram-negative bacilli. Methods Polymerase chain reaction （PCR） was used to detect disinfectant-resistant gene qacE△1-sul1 in 235 isolates from clinic, including 155 multidrug-resistant and 80 antimicrobial susceptible isolates. PCR products were sequenced by DNA sequencing. Results Among 50 strains of ESBLs-producing Escherichia coli , 27 ESBLs-producing Klebsiella pneumoniae , 50 MDR Pseudomonas aeruginosa , and 28 MDR Acineto bacter baumannii, disinfectant-resistant gene qacE△1-sul1 were detected in 37 （74. 00%）, 24 （88. 89%）, 46 （92. 00%）and 28 strains（100. 00%）,respectively, the total detection rate was 87. 10%; Among non-ESBLs-producing antimicrobial susceptible isolates of Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa , and Acinetobacter baumannii （each were 20 isolates）, disinfectant-resistant gene qacE△1-sul1 were detected in 16 （80. 00 % ）, 7 （35.00 %）, 5 （25.00 % ） and 13 strains（65.00 %）, respectively, the total detection rate of qacE△1-sul1 gene was 51.25%. Conclusion Disinfectant-resistant gene qacE△1-sul1 has a high detection rate in clinical MDR gram-negative bacilli in this hospital, it is important to the rational use of disinfectant by intensifying the monitor on the disinfectant-resistance of MDR.