医院常见致病菌的消毒剂药敏试验及质粒分析

目的]对医院常见致病菌进行消毒剂药敏试验,对耐药菌株进行质粒特征分析,为消毒剂规范合理使用提供参考。方法]在泰州地区5所医院的各类环境、高危科室、使用中消毒剂进行采样,在样品中分离和鉴定4种常见致病菌（金黄色葡萄球菌,表皮葡萄球菌,大肠杆菌,绿脓杆菌）。选择分离得到的菌株,在常用高中低效消毒剂内分别选取1种（84、碘伏、醋酸氯已定）,测定消毒剂对菌株的最低抑菌浓度（MIC）、最低杀菌浓度（MBC）,确定耐药菌株。对消毒剂耐药菌株提取质粒,采用琼脂糖凝胶电泳法进行质粒特征分析,并以相应的标准菌株作比较。结果]分离4种致病菌共90株,金黄色葡萄球菌、表皮葡萄球菌、大肠杆菌、绿脓杆菌对碘伏、醋酸氯已定未发现抗药性产生;表皮葡萄球菌、大肠杆菌、绿脓杆菌对84未发现抗药性产生;分离出6株金黄色葡萄球菌对84已经产生抗药性。金黄色葡萄球菌84抗性株与敏感株质粒特征比较显示两者有统计学差异。结论]医院消毒剂使用不合理,尤其是高效消毒剂滥用,可致使医院菌株对常用消毒剂产生抗药性,抗药机理与细菌耐药质粒产生有关。

STUDY ON DISINFECTANT SUSCETIBILITY TEST AND PLASMID ANALYSIS OF COMMON PATHOGENIC BACTERIUM IN HOSPITAL

Objective]To detect common pathogenic bacterium by disinfectant susceptibility test and analyze plasmid signature of drug resistant strain so as to provide basis for standard and resonable use of the disinfectants.Methods]Samples were taken from different environment of hospitals,high-risk departments,and in-use disinfectants.4 common pathogen(Staph.Aureus,P.aeruginosa,E.coli,and Staph.Epidermidis) were separated and evaluated from samples.These strains separated were separately detected by high,middle and low effect disinfectants(84,iodophor and chlorhexi-dine acetate) ,and the MIC and MBC of these disinfectants toward strains were determined.Finally,the drug resistant strains were identified.Agar gel electrophoresis method was conducted to detect plasmid signature analysis of drug resistant strains extracted,which were compared with corresponding reference strains.Results]A total of 90 strains of these 4 sorts of pathogen were separated.Out of them,Staph.Aureus,P.aeruginosa,E.coli,and Staph.Epidermidis did not show drug resistance to iodophor and chlorhexi-dine acetate;P.aeruginosa,E.coli,and Staph.Epidermidis did not revealed drug resisitance to 84,while 6 strains of Staph.Aureus showed drug resistance.The plasmid signature of resistant strains of Staph.Aureus showed significant difference when compared with that of sensitive strains.Conclusion]Unreasonable use of disinfectant in hospital,especially the misuse of high effect disinfectant,can lead to drug resistance of pathogen toward common disinfectants.The mechanism was associated with bacterium plasmid.