医院与社区获得性感染大肠埃希菌耐消毒剂基因比较分析  

Comparison of disinfectant-resistant genes in Escherichia coli between hospital-acquired infection and community-acquired infection

作　　者：陈磊[1] 夏大静[2] 

机构地区：[1]浙江大学医学院附属邵逸夫医院检验科,浙江杭州310016 [2]浙江大学医学院,浙江杭州310003

出　　处：《中国微生态学杂志》2013年第2期168-170,共3页Chinese Journal of Microecology

摘　　要：目的比较在本地区医院感染与社区获得性大肠埃希菌中耐消毒剂基因的流行情况。方法收集从临床标本中分离出的大肠埃希菌112株,根据感染途径不同,将其分为医院与社区获得性两组,用PCR方法检测耐消毒剂基因qacEΔ1,并进行组间检出率比较。结果本地区医院与社区获得性感染大肠埃希菌耐消毒剂基因的携带率分别为58.1%(43/74)和23.7%(9/38),组间比较差异有统计学意义(P<0.05);74株医院获得性大肠埃希菌中,产ESBL率为71.6%(53/74),38株社区获得性大肠埃希菌中,产ESBL率为39.5%(15/38)。医院与社区获得性产ESBL大肠埃希菌耐消毒剂基因qacEΔ1检出率分别为64.2%(34/53)与6.7%(1/15),组间比较差异亦有统计学意义(P<0.01)。结论医院获得性感染大肠埃希菌耐消毒剂基因的携带率高于社区获得性大肠埃希菌,产ESBL阳性菌株的携带率显著高于产ESBL阴性菌株,这可能是由于医院环境中消毒剂选择压力和/或携带耐消毒剂基因的菌株在医院内水平传播速度较快的结果。Objective To compare the prevalence of disinfectant-resistant genes between nosocomial infection and community-acquired Escherichia coli.Methods 112 Escherichia coli strains were collected from clinical specimens and divided into two groups,nosocomial infection group and community acquired infection group.Disinfectant-resistant gene qacEΔ1 was detected by PCR,and the detection rates were compared between the two groups.Results Detection rates of disinfectant-resistant genes of nosocomial infection and community-acquired Escherichia coli were 58.1%（43/74） and 23.7%（9/38） respectively.There was a significant difference between the two groups（χ2=11.96,P〈0.01）;ESBL-producing strains accounted for 71.6%（53/74） in nosocomial infection isolates,while only 39.5%（5/38） in the community-acquired ones.The detection rates of qacEΔ1 were 64.2%（34/53） and 6.7%（1/15） respectively in ESBL-producing nosocomial infection E.coli and ESBL-producing community-acquired E.coli.There was also a significant difference between the two groups（χ^2=15.47,P〈0.01）.Conclusion The positive rate of disinfectant-resistant genes in nosocomial infection E.coli is higher than that in community-acquired ones,and the positive rate of disinfectant-resistant genes in ESBL-positive strains is significantly higher than in the negative ones.These may be caused by the selection pressure of disinfectants and/or the prevalence of the strains carrying disinfectant-resistant gene in the hospital environment.

关 键 词：医院获得性感染 社区获得性感染 大肠埃希菌 耐消毒剂基因 ESBL 

分 类 号：R378.21[医药卫生—病原生物学]