多药耐药鲍氏不动杆菌耐消毒剂qacEΔ1基因检测研究

Disinfectant-resistant gene qacEΔ1 in multidrug-resistant Acinetobacter baumannii

目的了解医院分离的多药耐药鲍氏不动杆菌耐消毒剂qacEΔ1基因分布,为医院规范消毒技术和减少鲍氏不动杆菌感染提供科学依据。方法收集医院2013年8月-2013年11月分离的非重复多药耐药鲍氏不动杆菌26株,采用Phoenix100微生物全自动鉴定系统进行菌株鉴定及药敏试验;采用PCR方法检测qacA/B、qacC、qacEΔ1、qacG、qacJ基因;药敏数据采用WHONET5.6软件进行统计分析。结果 26株鲍氏不动杆菌标本来源以痰液为主,占84.7%;科室分布内科ICU检出最多,占53.9%;检出qacEΔ1基因阳性19株,阳性率73.1%;qacA/B基因2株,阳性率7.7%;未检出qacC、qacG、qacJ基因;26株多药耐药鲍氏不动杆菌对四环素、阿米卡星、庆大霉素耐药率分别为73.1%、73.1%、96.2%,对其余11种抗菌药物耐药率均为100.0%,仅对多黏菌素无耐药株,呈现多药耐药性。结论医院鲍氏不动杆菌耐消毒剂qacEΔ1基因携带率已非常高,规范消毒技术和制定标准化操作程序,以控制或延缓细菌对耐消毒剂基因的产生和蔓延。

OBJECTIVE To investigate the distribution of disinfectant-resistant gene qacEΔ1in clinical isolates of multidrug-resistant Acinetobacter baumannii so as to provide scientific basis for standard disinfection and reduce the incidence of A.baumannii infection.METHODS A total of 26non-repetitive A.baumannii isolates were collected from Aug 2013 to Nov 2013,then the strains were identified by using Phoenix100 microorganism automatic identification system,and the drug susceptibility testing was carried out;the qacA/B,qacC,qacEΔ1,qacG,and qacJgenes were detected by means of PCR,and the statistical analysis of the drug susceptibility testing data was performed with the use of WHONET5.6software.RESULTS Of 26 strains of A.baumannii,84.7% were isolated from sputum specimens;53.9% were isolated from the ICU of internal medicine department.The qacEΔ1gene was detected positive in 19 strains with the positive rate of 73.1%;the qacA/Bgene was detected positive in 2strains with the positive rate of 7.7%;while the qacC,qacG,and qacJgenes were not detected.The drug resistance rates of the 26 strains of multidrug-resistant A.baumannii to tetracycline,amikacin,and gentamicin were73.1%,73.1%,and 96.2%,respectively;the drug resistance rate to the rest of 11 kinds of antibiotics was100.0%.The polymyxin-resistant strains were not detected,and the strains were multidrug-resistant.CONCLUSIONThe carrying rate of the disinfectant-resistant gene qacEΔ1is so high in the A.baumannii strains that the standard operation procedures for disinfection should be developed so as to control or delay the occurrence and spread of the disinfectant-resistant genes.