北京某区医疗机构环境致病菌耐药性和消毒剂抗性研究  

Study on the drug resistance and disinfectant resistance of pathogens isolated from environment and surface in the medical institutions in a district of Beijing

作　　者：刘洁[1] 王会平[1] 董歧[1] 张洪江[1] 葛军旗[1] 戴玉来[1] 段杉[1] 李书明[1] LIU Jie WANG Hui-ping DONG Qi ZHANG Hong-jiang GE Jun-qi DAI Yu-lai DUAN Shan LI Shu-ming(Beijing Chaoyang District Center for Disease Control and Prevention,Beijing 100021 ,China)

机构地区：[1]北京市朝阳区疾病预防控制中心,北京100021

出　　处：《中国消毒学杂志》2016年第9期850-852,共3页Chinese Journal of Disinfection

基　　金：首都卫生发展科研专项(2011-7023-03)

摘　　要：目的研究医疗机构内环境物体表面致病菌的耐药性和抗消毒剂状况。方法采用肉汤稀释法和药敏试验法,对医疗机构内物体表面分离的致病菌耐药性和抗消毒剂情况进行测定。结果共分离出病原菌63株,其中革兰阴性菌54株,占85.71%,革兰阳性菌9株,占14.29%。分离到的细菌以铜绿假单胞菌和阴沟肠杆菌为主,药敏结果显示分离到的细菌均存在不同程度的耐药。通过消毒剂抗性试验,发现对醋酸氯已定分离到的肠杆菌中16株(16/18,88.89%)抵抗力大于标准菌株,铜绿假单胞菌中16株(16/25,64.00%)的抵抗力高于标准菌株,葡萄球菌中4株(4/5,80%)高于标准菌株;对含氯消毒剂(三氯异氰尿酸)分离到的肠杆菌中9株(9/18,50.00%)抵抗力大于标准菌株,分离到的铜绿假单胞菌中12株(12/25,48.00%)的抵抗力高于标准菌株,葡萄球菌中2株(2/5,40.00%)高于标准菌株。结论环境致病菌存在耐药和对消毒剂抵抗现象,除了严格执行环境及医护人员手部消毒以外,还应定期进行环境致病菌耐药性和消毒剂抗性的监测,并针对不同科室制定合理的消毒方案,防止耐药菌及消毒剂抗性菌的播散。Objective To investigate the drug resistance and disinfectant resistance of pathogens isolated from environment and surface in the medical institutions. Methods Drug resistance and disinfectant resistance of pathogenic bacteria isolated from medical institutions were determined by broth dilution method and drug sensitivity test method. Results 63 strains of pathogen were isolated,including 54 strains of Gram-negative bacteria（14. 29%）and 9 strains of Gram-positive bacteria（85. 71%） . Pseudomonas aeruginosa and Enterobacter cloacae were the main pathogens and all pathogens were showed various de-gree of drug-resistance. The disinfectant resistance test showed that the resistance of 16 strains of Enterobacter cloacae isolated （16/18,88. 89%）to Chlorhexidine Acetate were greater than that of the standard strain,16 strains of Pseudomonas aeruginosa isolated（16/25,64. 00%）were greater than that of the standard strain,4 strains of Staphylococcus isolated（4/5,80. 00%）were greater than that of the standard strain;the resistance of 9 strains of Enterobacter cloacae isolated（9/18,50. 00%）to Chlorine containing disinfectant（ three chloro isocyanuric acid） were greater than that of the standard strain,12 strains of Pseudomonas aeruginosa isolated（12/25,48. 00%） were greater than that of the standard strain,2 strains of Staphylococcus isolated（2/5, 40. 00%）were greater than that of the standard strain. Conclusion There are drug resistance and disinfectant resistance in the environment. In addition to strict implementation of environmental and medical personnel hand disinfection,we should reg-ularly carry out environmental pathogenic bacteria resistance and disinfectant resistance monitoring,and for different depart-ments to develop a reasonable disinfection program to prevent the spread of resistant bacteria and disinfectant resistance.

关 键 词：医疗机构 环境与物体表面 致病菌 耐药性 消毒剂抗性 

分 类 号：R187.1[医药卫生—流行病学]