医院环境中革兰阴性非发酵菌对醋酸氯己定的抗力观察

Observation on resistance of gram-negative non-fermenting bacteria to chlorhexidine acetate in hospital environment

目的通过对黑龙江省医疗机构内医院感染重点科室、重点部位的物体表面标本采集、分离,研究医院环境中物体表面的革兰阴性非发酵菌对醋酸氯己定的抗力变化情况,规范消毒剂的合理使用。方法采用细菌检测和肉汤稀释法,对医院环境标本进行细菌分离鉴定,并测定分离的革兰阴性非发酵菌对醋酸氯己定的最小抑菌浓度(MIC)和最小杀菌浓度(MBC)。结果从176份医院环境表面标本中共分离出15株革兰阴性非发酵菌,分离率为8. 52%。醋酸氯己定对革兰阴性非发酵菌的MIC均为5mg/L,MBC为5mg/L^312mg/L。结论医院环境中分离的革兰阴性非发酵菌的MIC均低于标准菌株铜绿假单胞菌,1株腐败假单胞菌对醋酸氯己定的MBC与标准菌株相同。医疗机构应对病原菌的消毒剂抗力情况持续关注,维持病原菌对各类消毒剂的敏感性,确保消毒效果的同时,尽量避免对环境的污染。

Objective Through collecting and separating surface samples from key departments and parts of hospital infection in several medical institutions in Heilongjiang,the changes of resistance of gram-negative non-fermenting bacteria to chlorhexidine acetate on the surface of objects in hospital environment were studied,and standardize the rational use of disinfectants.Methods Bacterial test and broth dilution method were used to isolate and identify the environmental samples of hospitals,and the minimum inhibitory concentration(MIC)and minimum bactericidal concentration(MBC)of isolated gramnegative non-fermentative bacteria against chlorhexidine acetate were determined.Results A total of 15 gram-negative non-fermentative bacteria were isolated from 176 hospital environmental surface samples with a separation rate of 8.52%.The MIC value of chlorhexidine acetate to gram-negative non-fermenting bacteria was 5 mg/L,and the MBC value ranged from 5 mg/L to 312 mg/L.Conclusion The MIC value of gram-negative non-fermenting bacteriaseparated from hospital environment is lower than that of the standard strain(10 mg/L).The MBC value of one strain of Pseudomonas spp.to chlorhexidine acetate is the same as that of the standard strain(312 mg/L).Medical institutions should pay continuous attention to the resistance of pathogenic bacteria to disinfectants,maintain the sensitivity of pathogenic bacteria to various disinfectants,ensure the disinfection effect,and try to avoid environmental pollution.