导管相关血流感染多重耐药鲍曼不动杆菌对常用消毒剂的抗性研究  

Study on resistance of multidrug resistant Acinetobacter baumannii to common disinfectants in catheter-associated bloodstream infections

作　　者：钦晓英[1] 张烨[1] 花扣珍[2] 朱薇[1] QIN Xiao-ying;ZHANG Ye;HUA Kou-zhen;ZHU Wei(Zhejiang Provincial People's Hospital,People's Hospital Affiliated to Hangzhou Medical College,Hangzhou,Zhejiang 310014,China;不详)

机构地区：[1]浙江省人民医院杭州医学院附属人民医院,浙江杭州310014 [2]杭州医学院,浙江杭州310053

出　　处：《中国卫生检验杂志》2021年第4期410-413,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技计划项目(2019ZH017)。

摘　　要：目的探讨导致导管相关血流感染(CLABSI)的鲍曼不动杆菌药敏结果、对常用消毒剂的抗性水平、耐消毒剂基因qac EΔ1携带率。方法 VITEK 2鉴定菌株并检测对抗生素的敏感性,肉汤稀释法检测菌株对消毒剂的最低抑菌浓度(MIC),PCR检测菌株qac EΔ1携带率。结果 64.7%为多重耐药鲍曼不动杆菌(MDR-AB),5种代表性抗生素的耐药率为35.3%~70.6%。72.7%和54.5%的MDR-AB菌株对84消毒液和碘伏的MICs高于标准菌株的MIC,而非MDR-AB菌株则均小于等于标准菌株的MIC;94.1%的菌株对新洁尔灭消毒液的MICs均高于标准菌株的MIC。MDR-AB菌株qac EΔ1基因携带率(100.0%)明显高于非MDR-AB(66.7%)(P <0.05),鲍曼不动杆菌qac EΔ1基因总携带率为88.2%。结论本院CLABSI分离的鲍曼不动杆菌多重耐药率高,MDR-AB已对消毒剂产生抗性,消毒液的抗性可能与qac EΔ1基因的存在相关。Objective To investigate the drug susceptibility of A. baumannii to catheter related bloodstream infection( CLABSI),the resistance level to common disinfectants,and the carrying rate of disinfectant resistance gene qac EΔ1. Methods The susceptibility of isolates to antibiotics representing 5 classes of antibiotics were detected by VITEK 2 automatic microbial analyzer. The minimum inhibitory concentration( MIC) of isolates against three disinfectants was detected by broth dilution method,and the carrying rate of isolates qac EΔ1 was detected by PCR. Results A total of 64. 7% isolates were multidrug resistant A.baumannii( MDR-AB). The drug resistance rates of 5 antibiotics to 17 isolates were within 35. 3%-70. 6%. The MICs of72. 7% to 84 disinfectant and 54. 5% to iodine disinfectant of MDR-AB isolates were higher than MIC of standard strain,while the MIC of non-MDR-AB isolates were less than or equal to that of standard strain. MICs of 94. 1% strains to benzalkonium bromide solution were higher than that of the standard strain. The rate of qac EΔ1 gene in MDR-AB isolates was100. 0% significantly higher than that in Non-MDR-AB isolates( 66. 7%)( P < 0. 05),and the total carrying rate of acinetobacter baumannii qac EΔ1 gene was 88. 2%. Conclusion The multidrug resistance rate of A. baumannii isolated from CLABSI patients in our hospital is high. MDR-AB isolates has been resistant to disinfectant,and the disinfectant may be related to the existence of qac EΔ1 gene.

关 键 词：导管相关血流感染 鲍曼不动杆菌 耐消毒剂基因 抗性 

分 类 号：R446.5[医药卫生—诊断学]