临床分离肺炎克雷伯杆菌对消毒剂耐药性观察  

Observation on drug resistance of clinical isolated Klebsiella pneumoniae

作　　者：王文英[1] 陈勇[2] 张亚萍[1] 韩黎[2] 叶明[1] 赵明利[1] 庞晓宁[1] 

机构地区：[1]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

出　　处：《中国消毒学杂志》2016年第7期635-638,共4页Chinese Journal of Disinfection

基　　金：兰州战区引学研究课题(CLZ13JA08)

摘　　要：目的观察临床分离的肺炎克雷伯杆菌对常用消毒剂的耐药情况及抗消毒剂基因携带状况。方法采用琼脂扩散法和聚合酶链反应法,对96株临床肺炎克雷伯杆菌抗消毒剂和抗性基因携带情况进行检测。结果 3种季铵盐和三氯生对96株肺炎克雷伯杆菌的MIC值均高于标准菌株,氯己定对96株肺炎克雷伯菌中的93株MIC值高于标准株。临床分离的肺炎克雷伯菌qac EΔ1和qac E携带率均为76.0%;qac E-qac EΔ1携带率为70.8%。qac E、qac EΔ1和sug E(c)阳性菌株对三氯生、溴化铵、苯扎氯铵和醋酸氯己定等消毒剂抗性较阴性菌株强。结论该医院临床分离的肺炎克雷伯杆菌对3类低效消毒剂显示出抗力增强的趋势,消毒剂抗性基因携带率也比较高,提示慎用低效消毒剂消毒关键性物品。Objective To observe the drug resistance of clinical isolated Klebsiella pneumoniae to the commonly used disinfectants and the status of the drug resistance gene. Methods Using the agar diffusion method and polymerase chain reaction method,96 strains of Klebsiella pneumoniae were detected. Results The MIC values of 96 strains of Klebsiella pneumonia to three kinds of quaternary ammonium salt and triclosan were higher than those of standard strain. And MIC values of93 of 96 strains of Klebsiella pneumoniae were higher than those of standard strains. Among 96 strains with Klebsiella pneumoniae,the carrying rate of disinfectant resistance gene qac EΔ1 and qac E was both 76. 0%,the carrying rate of qac E-qac EΔ1 was 70. 8%. The disinfectant resistance of carrying qac E,qac EΔ1 and sug E（ c） of the positive strains was stronger than that of negative strains,which were used for triclosan,hexadecyltrimethylammonium bromide,ammonium bromide,chlorhexidine. Conclusion Clinical isolated Klebsiella pneumoniae in the hospital showes a trend of increased resistance to three types of low efficiency disinfectants. Disinfectant resistant gene carrying rate is also relatively high,which means low effect disinfectant should be chosen carefully.

关 键 词：肺炎克雷伯杆菌 消毒剂抗性 抗性基因 聚合酶链反应 

分 类 号：R187.2[医药卫生—流行病学]