养老机构环境致病性肠球菌污染状况调查及其耐药性和消毒剂抗性研究  

Investigation of contamination status, antibiotic resistance, and disinfectant resistance of pathogenic Enterococcus in the environment of elderly care institutions

作　　者：朱陈雪 吴晓松 王玲[2] 范晶晶[2] 沈益鸣[2] 邹文艺 徐燕 ZHU Chen-xue;WU Xiao-song;WANG Ling;FAN Jing-jing;SHEN Yi-ming;ZOU Wen-yi;XU Yan(School of Public Health,Nanjing Medical University,Nanjing 211166,China;Jiangsu Provincial Center for Disease Control and Prevention;Jiangsu Provincial Medical Key Laboratory of Pathogenic Microbiology in Emerging Major Infectious Diseases;National Health Committee Key Laboratory of Enteric Pathogenic Microbiology;School of Public Health,Xuzhou Medical University)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]江苏省疾病预防控制中心 [3]江苏省新发突发重大传染病病原微生物重点实验室 [4]国家卫生健康委员会肠道病原微生物重点实验室 [5]徐州医科大学公共卫生学院

出　　处：《中国消毒学杂志》2025年第3期182-185,共4页Chinese Journal of Disinfection

基　　金：江苏省卫生健康委科研项目(ZDA2020015,K2019008,LGY2019074)。

摘　　要：目的 了解养老机构环境表面病原微生物污染状况,分析致病性肠球菌的耐药性及其对常用环境消毒剂的抗性。方法 现场采集养老机构环境表面样本,检测病原菌污染情况,对致病性肠球菌进行分离鉴定和药敏试验;采用营养肉汤稀释法,检测致病性肠球菌对含氯消毒剂、乙醇和季铵盐类消毒剂的抗性。结果 193份环境样本中分别检出金黄色葡萄球菌、铜绿假单胞菌和肠球菌20、2和19株,检出率分别为10.4%、1.0%和9.8%;肠球菌包括9株粪肠球菌和10株屎肠球菌。非医养结合型机构屎肠球菌检出率高于医养结合型机构(9.0%vs 1.1%;χ^(2)=4.652,P=0.031)。19株肠球菌中耐药菌占68.4%,多重耐药菌占15.8%。含氯消毒剂、单链季铵盐类消毒剂对部分肠球菌的最小抑菌浓度(MIC)和最小杀菌浓度(MBC)高于标准菌株。结论 养老机构环境表面肠球菌检出率较高,部分菌株具有耐药性及消毒剂抗性,应加强环境卫生管理,并结合耐药性和消毒剂抗性情况科学防治致病性肠球菌医院感染。Objective To investigate the contamination status of pathogenic microorganisms on environmental surfaces in elderly care institutions,and to analyze the antibiotic resistance of pathogenic Enterococcus as well as their resistance to commonly used environmental disinfectants.Methods Field collection of environmental surface samples in elderly care institutions was conducted to assess the contamination status of pathogenic bacteria.Pathogenic Enterococcus were isolated,identified,and subjected to antibiotic susceptibility testing.Using the broth dilution method,the resistance of these pathogenic Enterococcus to chlorine-based disinfectants,ethanol,and quaternary ammonium compounds was evaluated.Results Among the 193 environmental samples,20 strains of Staphylococcus aureus,2 strains of Pseudomonas aeruginosa,and 19 strains of Enterococcus were detected,with detection rates of 10.4%,1.0%,and 9.8%respectively.The Enterococcus included 9 strains of Enterococcus faecalis and 10 strains of Enterococcus faecium.The detection rate of Enterococcus faecium was higher in non-medical-elderly care institutions compared to that in medical-elderly care institutions(9.0%vs 1.1%;χ^(2)=4.652,P=0.031).Among the 19 strains of Enterococcus,68.4%were resistant to antibiotics,and 15.8%were multidrug-resistant.For some Enterococcus the minimum inhibitory concentration(MIC)and minimum bactericidal concentration(MBC)values against chlorine-based disinfectants and monochain quaternary ammonium compounds were higher than those of standard strains.Conclusion The detection rate of Enterococcus on the environmental surfaces of elderly care institutions is relatively high,and some strains exhibit drug resistance and disinfectant resistance.Therefore,it is necessary to strengthen the environmental hygiene management in elderly care institutions,and to scientifically prevent and treat hospital acquired infections of pathogenic enterococci based on drug resistance and disinfectant resistance.

关 键 词：养老机构 肠球菌 耐药性 消毒剂抗性 

分 类 号：R378[医药卫生—病原生物学] R187[医药卫生—基础医学]