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目的研究医院环境中分离出的致病菌株对常用消毒剂的敏感性,为科学选择有效消毒剂提供依据。方法检测苯扎溴铵、含氯消毒剂和碘伏对临床分离的致病菌株的最小抑菌浓度(MIC)、最小杀菌浓度(MBC),与标准范围比较判断致病菌的抗消毒剂情况;采用聚合酶链反应(PCR)检测抗性基因qacE△1-sul1的携带情况。结果自医院内环境中分离的多重耐药菌包括铜绿假单胞菌30株、肺炎克雷伯杆菌10株、鲍曼不动杆菌6株。其中铜绿假单胞菌占65.2%,远高于其他两种致病菌。25株铜绿假单胞菌检出qacE△1-sul1抗性基因,携带率为80.33%;肺炎克雷伯杆菌2株检出qacE△1-sul1抗性基因,携带率为20.00%,鲍曼不动杆菌抗性基因未检出。三者差异的比较具有统计学意义。结论医院外环境中有多重耐药致病菌株的存在,部分菌种或个别菌株对常用消毒剂存在抗性。建议临床根据监测情况对消毒剂的时间浓度做适时调整,及时更换产生耐药菌株较多的消毒剂,做好环境清洁和手卫生消毒,减少致病菌耐药菌株的产生。
Objective To study the sensitivity of the pathogenic strains isolated from the hospital environment to commonly used disinfectants and to provide a basis for the scientific selection of effective disinfectants. Methods The minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBC) of benzalkonium bromide, chlorinated disinfectants and iodophor were tested against the clinically isolated strains. The antimicrobial agents against the pathogenic bacteria were compared with the standard range ; Carrying the detection of resistance gene qacE △ 1-sul1 by polymerase chain reaction (PCR). Results The multi-drug resistant strains isolated from the hospital environment included 30 strains of Pseudomonas aeruginosa, 10 strains of Klebsiella pneumoniae and 6 strains of Acinetobacter baumannii. Pseudomonas aeruginosa which accounted for 65.2%, much higher than the other two pathogens. 25 strains of Pseudomonas aeruginosa detected qacE △ 1-sul1 resistance gene, the carrying rate was 80.33%; 2 strains of Klebsiella pneumoniae detected qacE △ 1-sul1 resistance gene, carrying rate of 20.00%, Bowman Acinetobacter resistance gene was not detected. The difference between the three was statistically significant. Conclusion There are multiple drug-resistant pathogenic bacteria in the external environment of the hospital. Some strains or individual strains are resistant to commonly used disinfectants. It is recommended that clinical monitoring of the time concentration of disinfectant to make timely adjustments, timely replacement of more resistant strains of disinfectants, good environmental sanitation and hand sanitation disinfection, reducing the generation of pathogenic bacteria resistant strains.