多重耐药革兰阴性杆菌耐消毒剂基因qacE△1sul1监测

Surveillance on disinfectantresistant gene qacE△1sul1 in multidrugresistant gramnegative bacilli

摘要:

目的了解某院临床常见革兰阴性(G-)杆菌多重耐药株耐消毒剂基因qacE△1sul1的产生情况。方法收集临床分离的G-杆菌235株，包括155株多重耐药株和80株敏感株，采用聚合酶链反应（PCR）法检测qacE△1sul1基因，并进行DNA测序。结果在50株产超广谱β内酰胺酶（ESBLs）大肠埃希菌、27株产ESBLs肺炎克雷伯菌、50株多重耐药的铜绿假单胞菌和28株多重耐药的鲍曼不动杆菌中，检出qacE△1sul1 株分别为37、24、46、28株，检出率分别为74.00％、88.89%、92.00%和100.00％，总的检出率为87.10％；在非产ESBLs的大肠埃希菌、肺炎克雷伯菌以及铜绿假单胞菌和鲍曼不动杆菌的敏感株（各20株）中，分别检出qacE△1sul1株 16、7、5、13株，检出率分别为80.00％、35.00%、25.00%和65.00％，总的检出率为51.25％。结论该院G-杆菌多重耐药株耐消毒剂基因qacE△1sul1的携带率较高，加强多重耐药菌对消毒剂耐药性的监测，对临床合理使用消毒剂具有重要意义。

Abstract:

ObjectiveTo investigate  the disinfectantresistant gene qacE△1sul1 in clinical multidrugresistant (MDR) gramnegative bacilli.MethodsPolymerase chain reaction (PCR) was used to detect disinfectantresistant gene qacE△1sul1 in 235 isolates from clinic，including 155 multidrugresistant and 80 antimicrobial susceptible isolates. PCR products were sequenced by DNA sequencing.ResultsAmong 50 strains of  ESBLsproducing Escherichia coli, 27 ESBLsproducing Klebsiella pneumoniae, 50 MDR Pseudomonas aeruginosa, and  28  MDR Acinetobacter baumannii，disinfectantresistant gene qacE△1sul1 were detected in 37（74.00%）,24（88.89%）,46（92.00%）and 28 strains（100.00%）,respectively， the total detection rate was 87.10%; Among nonESBLsproducing antimicrobial susceptible isolates of Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa, and Acinetobacter baumannii （each were 20 isolates），disinfectantresistant gene qacE△1sul1 were detected in 16（80.00%）,7（35.00%）,5 （25.00%）and 13 strains（65.00%）,respectively, the total detection rate of qacE△1sul1 gene was 51.25％.ConclusionDisinfectantresistant gene qacE△1sul1 has a high detection rate in clinical MDR gramnegative bacilli in this hospital, it is important to the rational use of disinfectant by  intensifying  the monitor on the disinfectantresistance of MDR .