确定耐碳青霉烯类肺炎克雷伯菌对常用消毒剂的耐药性并阐明其潜在的耐药机制。

Determining the resistance of carbapenem-resistant Klebsiella pneumoniae to common disinfectants and elucidating the underlying resistance mechanisms.

作者信息

Guo Wei, Shan Kai, Xu Bin, Li Jianguo

出版信息

Pathog Glob Health. 2015 Jun;109(4):184-92. doi: 10.1179/2047773215Y.0000000022. Epub 2015 Jul 17.

DOI:10.1179/2047773215Y.0000000022

PMID:26184804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4530556/

Abstract

INTRODUCTION

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection is a serious problem in hospitals worldwide, posing a particular risk to immunocompromised patients. Elimination strategies may prevent these drug-resistant bacteria from spreading within hospital environments. Here, the susceptibility of patient-derived CRKP strains to common chemical disinfectants and possible correlations between the presence of drug-resistance genes and increased resistance to disinfectants were investigated.

METHODS

The minimum inhibitory (MIC) and the minimum bactericidal concentrations (MBC) of common chemical disinfectants against each CRKP strain were determined using agar dilution; K. pneumoniae ATCC700603 served as a standard. The presence of the drug-resistance genes qacΔE, qacA, acrA and qacE was determined using PCR.

RESULTS

A total of 27 clinically isolated CRKP strains collected in our hospital from 2011 to 2013 exhibited sensitivity to the following common chemical disinfectants in decreasing order of sensitivity: 75% ethyl alcohol > 2% glutaraldehyde > "84" disinfectant > 0.2% benzalkonium bromide > 2% iodine tincture > 1% iodophor > 0.1% chlorhexidine acetate. Of the 27 strains, 59, 41, 19 and 15% contained qacΔE, qacA, acrA and qacE resistance genes; 15% carried acrA, qacΔE and qacA, and 26% carried both qacA and qacΔE. Comparative analysis indicated that drug-resistance genes were correlated with higher MIC values.

CONCLUSION

These pan-resistant pathogenic CRKP strains contained various drug-resistance genes and exhibited relatively high resistance to ethyl alcohol, chlorhexidine acetate and iodophor. Monitoring the drug-resistance rates of CRKP strains displaying disinfectant resistance may facilitate appropriate and effective sterilisation and thus preventing the spread of these pan-resistant strains.

摘要

引言

耐碳青霉烯类肺炎克雷伯菌（CRKP）感染是全球医院面临的一个严重问题，对免疫功能低下的患者构成特别风险。消除策略可能会阻止这些耐药菌在医院环境中传播。在此，研究了患者来源的CRKP菌株对常见化学消毒剂的敏感性以及耐药基因的存在与对消毒剂耐药性增加之间的可能相关性。

方法

采用琼脂稀释法测定常见化学消毒剂对各CRKP菌株的最低抑菌浓度（MIC）和最低杀菌浓度（MBC）；肺炎克雷伯菌ATCC700603作为标准菌株。采用PCR法检测耐药基因qacΔE、qacA、acrA和qacE的存在情况。

结果

2011年至2013年在我院收集的27株临床分离CRKP菌株对以下常见化学消毒剂的敏感性由高到低依次为：75%乙醇＞2%戊二醛＞“84”消毒液＞0.2%苯扎溴铵＞2%碘酒＞1%碘伏＞0.1%醋酸氯己定。在这27株菌株中，59%、41%、19%和15%含有qacΔE、qacA、acrA和qacE耐药基因；15%携带acrA、qacΔE和qacA，26%同时携带qacA和qacΔE。比较分析表明，耐药基因与较高的MIC值相关。