医院环境分离致病菌对常用消毒剂的抗性

Research on the disinfectant resistance of pathogenic bacteria isolated from hospital surrounding

目的研究医院环境中分离出的致病菌株对常用消毒剂的敏感性,为科学选择有效消毒剂提供依据。方法检测苯扎溴铵、含氯消毒剂和碘伏对临床分离的致病菌株的最小抑菌浓度(MIC)、最小杀菌浓度(MBC),与标准范围比较判断致病菌的抗消毒剂情况;采用聚合酶链反应(PCR)检测抗性基因qacE△1-sul1的携带情况。结果自医院内环境中分离的多重耐药菌包括铜绿假单胞菌30株、肺炎克雷伯杆菌10株、鲍曼不动杆菌6株。其中铜绿假单胞菌占65.2%,远高于其他两种致病菌。25株铜绿假单胞菌检出qacE△1-sul1抗性基因,携带率为80.33%;肺炎克雷伯杆菌2株检出qacE△1-sul1抗性基因,携带率为20.00%,鲍曼不动杆菌抗性基因未检出。三者差异的比较具有统计学意义。结论医院外环境中有多重耐药致病菌株的存在,部分菌种或个别菌株对常用消毒剂存在抗性。建议临床根据监测情况对消毒剂的时间浓度做适时调整,及时更换产生耐药菌株较多的消毒剂,做好环境清洁和手卫生消毒,减少致病菌耐药菌株的产生。

Objective To study the sensitivity of pathogenic bacteria isolated from hospital settings to disinfectants commonly used,so as to provide the basis for scientific and effective disinfectant. Methods The minimum inhibitory concentration（ MIC） and minimum bactericidal concentration（ MBC） tests were used to observe the disinfectant resistance of pathogenic bacteria isolated from clinic compared with the standard strains. The polymerase chain reaction（ PCR） method was used to detect the carrying rate of the resistance gene qacE△1-sul1. Results The multidrug-resistant bacteria isolated from the hospital environment included 30 strains of Pseudomonas aeruginosa,10 strains of Klebsiella pneumoniae and 6strains of Acinetobacter baumannii. The strains of Pseudomonas aeruginosa accounted for 65. 2%,which was much higher than the other two pathogens. The qacE△1-sul1 resistance gene was detected in 25 strains of Pseudomonas aeruginosa,and the carrying rate was 80. 33%; that was detected in 2 strains of Klebsiella pneumonia with the carrying rate of 20. 00%. This gene was not detected in Acinetobacter baumannii. The difference of the qacE△1-sul1 gene carrying rate of the three kinds of bacteria was statistically significant. Conclusion The hospital still has multiple drug-resistant strains of pathogens in the environment,and part of bacteria are resistant to disinfectants commonly used. So timely adjusting the suggested concentration of disinfectants based on the monitoring,timely replacement of disinfectants causing more resistance strains,environmental cleaning and disinfection of hand hygiene were suggested to reduce the occurrence of drug-resistant strains of pathogens.