检测中国一家三甲医院耐碳青霉烯类肺炎克雷伯菌和大肠埃希菌对常用消毒剂的敏感性。
Determining the susceptibility of carbapenem resistant Klebsiella pneumoniae and Escherichia coli strains against common disinfectants at a tertiary hospital in China.
机构信息
Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
Guangdong Province Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Research Center of Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
出版信息
BMC Infect Dis. 2020 Jan 30;20(1):88. doi: 10.1186/s12879-020-4813-6.
BACKGROUND
Carbapenem-resistant Enterobacteriaceae (CRE) infections have become a global health threat. Controlling CRE transmission in hospitals is increasingly dependent on the use of disinfectants to restrict the risk of infection. Here, the susceptibility of patient-derived carbapenem resistant Klebsiella pneumoniae (CRKP) and Escherichia coli (CREC) strains against three common disinfectants and the determinants of resistance to disinfectants were investigated.
METHODS
The minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of three common chemical disinfectants: chlorhexidine, trichloroisocyanuric (TCCA) acid and Povidone iodine (PVP-I) against 50 CRE strains were measured. The drug-resistance genes -qacEΔ1, qacA/B and cepA-were determined using polymerase chain reaction.
RESULTS
A total of 36 CRKP and 14 CREC strains were collected in our hospital from 2016 to 2018. The MIC ranges of 36 CRKP strains against chlorhexidine, TCCA and PVP-I were 8512 mg/L, 64128 mg/L and 8128 mg/L, respectively. For 14 CREC strains, the MIC ranges against chlorhexidine, TCCA and PVP-I were 4128 mg/L, 64128 mg/L and 4128 mg/L, respectively. Moreover, against chlorhexidine and PVP-I, the MIC of 36 CRKP strains was higher than that of 50 CSKP strains. The qacE△1 gene was detected in 15 isolates among 36 CRKP strains (41.7%), and 8 isolates among 14 CREC strains (57.1%); while the qacA/B gene was not detected. Specifically, the cepA gene was much more prevalent than the qacEΔ1; it reached over 80% among CRKP strains. Compared to the CSKP strains, the presence of the qacEΔ1 and cepA genes was significantly higher among the CRKP strains (p < 0.05).
CONCLUSION
CRE strains collected from patients in our hospital exhibit various degree of resistance to the commonly used chemical disinfectants. It is of great help to keep monitoring the tendency of the reduced susceptibility of the pan-resistant strains against disinfectants, in order to effectively control and prevent the spread of the super resistant bacteria.
背景
耐碳青霉烯类肠杆菌科（CRE）感染已成为全球健康威胁。控制医院内 CRE 的传播越来越依赖于消毒剂的使用，以限制感染风险。在此，研究了三种常见消毒剂对 50 株患者来源的耐碳青霉烯类肺炎克雷伯菌（CRKP）和大肠埃希菌（CREC）菌株的敏感性，以及消毒剂耐药性的决定因素。
方法
用最小抑菌浓度（MIC）和最小杀菌浓度（MBC）法测定 3 种常用化学消毒剂：洗必泰、三氯异氰尿酸（TCCA）酸和聚维酮碘（PVP-I）对 50 株 CRE 菌株的抑菌效果。采用聚合酶链反应（PCR）检测耐药基因-qacEΔ1、qacA/B 和 cepA。
结果
2016 年至 2018 年，我院共收集 36 株 CRKP 和 14 株 CREC 菌株。36 株 CRKP 株对洗必泰、TCCA 和 PVP-I 的 MIC 范围分别为 8512mg/L、64128mg/L 和 8128mg/L；14 株 CREC 株对洗必泰、TCCA 和 PVP-I 的 MIC 范围分别为 4128mg/L、64128mg/L 和 4128mg/L。此外，与 50 株 CSKP 株相比，36 株 CRKP 株对洗必泰和 PVP-I 的 MIC 值更高。在 36 株 CRKP 株中有 15 株（41.7%）检出 qacE△1 基因，14 株 CREC 株中有 8 株（57.1%）检出 qacE△1 基因；未检出 qacA/B 基因。具体来说，cepA 基因比 qacEΔ1 基因更为普遍，在 CRKP 株中超过 80%。与 CSKP 株相比，CRKP 株中 qacEΔ1 和 cepA 基因的存在显著更高（p<0.05）。
结论
我院患者分离的 CRE 株对常用化学消毒剂有不同程度的耐药性。不断监测泛耐药菌株对消毒剂敏感性降低的趋势，对于有效控制和预防超级耐药菌的传播非常有帮助。
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