武汉市某医院空调过滤网积尘中抗生素抗性基因污染状况

Antibiotic resistance gene contamination status in air conditioning filter dust of a hospital in Wuhan City

目的了解医院不同科室病房空调过滤网积尘中抗生素抗性基因污染种类、水平的差异。方法采用湿棉签刮擦法采集武汉市某三级甲等综合医院7个科室19个病区空调回风口过滤网积尘样本,采用聚合酶链式反应(PCR)定性检测6大类抗生素相关的24种抗生素抗性基因,并对6种典型的抗性基因进行荧光定量PCR检测。结果过滤网积尘中检出磺胺类(sulI、sulII)、β-内酰胺类(mecA、blaOXA-51、blaTEM、blaCTX-M、blaSHV、blaKPC、blaNDM-1、blaIMP、blaVIM)、氨基糖苷类[aac(6′)-aph(2″)、aacC2]、大环内酯类(ermA、ermC、ereA)、喹诺酮类(qnrA、qnrB、qnrS)共5大类19种抗生素抗性基因,包括4种碳青霉烯类抗性基因(blaNDM-1、blaIMP、blaVIM、blaKPC)。6种典型抗性基因绝对含量(拷贝/g)由高到低依次为:sulI(1.06×10~9)>sulII(1.78×10~8)>blaNDM-1(3.97×10~7)>aac(6′)-aph(2″)(3.20×10~7)>blaTEM(1.03×10~7)>aacC2(1.13×10~6)。7个科室中,以创伤外科检出抗性基因种类最多达18种,6种典型基因绝对含量均高于其他科室。ICU及外科病区6种典型基因绝对含量高于内科病区。结论该医院部分病房空调过滤网积尘中存在多种抗生素抗性基因,提示相关环境中可能存在与其有关的耐药菌现时或过往的污染。

OBJECTIVE To understand the differences in the types and levels of antibiotic resistance genes contamination in the dust of air conditioning filters in hospital inpatient wards. METHODS Wet cotton swabs were used to collect dust samples from air conditioning filters in 19 wards of 7 departments of a third-grade general hospital in Wuhan. The 24 antibiotic resistance genes related to 6 major antibiotics were qualitatively detected by PCR, and 6 typical resistance genes were detected by real-time PCR. RESULTS Sulfonamides(sulI, sulII),β-lactams(mecA, blaOXA-51, blaTEM, blaCTX-M, blaSHV, blaKPC, blaNDM-1, blaIMP, blaVIM), aminoglycosides(aac(6′)-aph(2″), aacC2), macrolides(ermA, ermC, ereA), quinolones(qnrA, qnrB, qnrS), a total of five categories of 19 antibiotic resistance genes were detected in the dust of the filter. These include four carbapenem resistance genes(blaNDM-1, blaIMP, blaVIM, blaKPC). The average of absolute content(copies/g) of the six typical resistance genes from high to low was: sulI(1.06×10~9)>sulII(1.78×10~8)>blaNDM-1(3.97×10~7)>aac(6′)-aph(2″)(3.20×10~7)>blaTEM(1.03×10~7)>aacC2(1.13×10~6). Among the seven tested departments, traumatic surgery detected up to 18 resistant gene species and 6 typical genes with the highest absolute content. The absolute content of six typical genes in ICU and surgical wards was higher than medical wards. CONCLUSION A variety of antibiotic resistance genes are detected in the dust of some hospital ward air conditioning filters, suggesting that there may be current or past pollution of resistant bacteria in the relevant environment.