临床分离大肠埃希菌耐消毒剂基因携带情况及5种消毒剂最低抑菌浓度  

Carriage of disinfectant resistance genes in clinically isolated Escherichia coli and minimal inhibitory concentration of five disinfectants

作　　者：张亚萍[1] 陈勇[2] 王文英[1] 韩黎[2] 韩雪玲[1] 刘彦君[1] 曹延霞 

机构地区：[1]中国人民解放军第三医院,陕西宝鸡721004 [2]军事医学科学院疾病预防控制所,北京100071

出　　处：《中国感染控制杂志》2016年第5期289-293,共5页Chinese Journal of Infection Control

基　　金：国家自然科学基金项目(81102168);兰州战区引起血流感染的多重耐药菌分子流行病学研究课题(CLZ13JA08)

摘　　要：目的了解临床标本分离的大肠埃希菌(E.coli)对常用消毒剂耐药性及其消毒剂耐药基因携带状况。方法采用聚合酶链反应(PCR)对82株E.coli耐消毒剂基因sugE(c)、sugE(p)、qacEΔ1和qacE进行检测,琼脂稀释法进行最低抑菌浓度(MIC)测定。结果临床分离的82株E.coli中,sugE(c)、sugE(p)、qacEΔ1、qacE、sugE(c)+qacEΔ1、qacE+qacEΔ1+sugE(c)阳性率分别为84.15%(69株)、1.22%(1株)、76.83%(63株)、73.17%(60株)、68.29%(56株)、59.76%(49株)。产超广谱β-内酰胺酶(ESBLs)与非产ESBLs菌株,头孢吡肟敏感株与耐药株4种耐消毒剂基因携带情况比较,差异均无统计学意义(均P>0.05)。苯扎氯铵、西吡氯铵、溴化铵及三氯生4种消毒剂对82株E.coli的MIC值均>标准菌株;氯己定对32株E.coli的MIC值>标准菌株,对另外50株E.coli的MIC值≤标准菌株。苯扎氯铵、西吡氯铵、溴化铵及三氯生对产ESBLs和非产ESBLs组、头孢吡肟敏感和耐药组的MIC值结果比较,差异均无统计学意义(均P>0.05);而氯己定MIC值比较,差异均有统计学意义(均P<0.05)。结论临床送检标本分离的E.coli耐消毒剂基因qacE、qacEΔ1和sugE(c)检出率高,苯扎氯铵等消毒剂对E.coli的MIC普遍较标准菌株明显升高。Objective To understand the disinfectant resistance of clinically isolated Escherichia coli（E.coli）and carriage of disinfectant resistance genes.Methods Disinfectant resistance gene sugE（c）,sugE（p）,qacEΔ1,and qacE of 82 isolates of E.coli were detected with polymerase chain reaction（PCR）,minimal inhibitory concentrations（MICs）were measured with agar dilution methods.Results Among 82 E.coli isolates,positive rates of disinfectant resistance gene sugE（c）,sugE（p）,qacEΔ1,qacE,sugE（c）＋qacEΔ1,and qacE＋qacEΔ1＋sugE（c）were 84.15%（n=69）,1.22%（n=1）,76.83%（n=63）,73.17 %（n=60）,68.29%（n=56）,and 59.76%（n=49）respectively.There was no significant differences in carriage status of four disinfectant resistance genes between extended-spectrumβ-lactamases（ESBLs）-producing and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains（all P〈0.05）;MIC values of benzalkonium chloride,cetylpyridinium chloride,ammonium bromide,and triclosan for 82 isolates of E.coli were all standard stain;MIC values of chlorhexidine for32 isolates of E.coli were all standard stain,for 50 other E.coli strains were all≤ standard strain.There were no significant difference in MIC values of benzalkonium chloride,cetylpyridinium chloride,ammonium bromide,and triclosan between ESBLs-and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains（all P〈0.05）;while MIC values of chlorhexidine showed a significant difference（both P〈0.05）.Conclusion Detection rates of disinfectant resistance gene qacE,qacEΔ1,and sugE（c）in E.coli from clinical specimens are high,MICs of disinfectants such as benzalkonium chloride for E.coli are generally higher than standard strain.

关 键 词：大肠埃希菌 耐消毒剂 基因 最低抑菌浓度 

分 类 号：R378[医药卫生—病原生物学]