ICU环境致病菌对常用消毒剂抗性的研究
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摘要
目的研究ICU环境中分离出的致病菌株对常用消毒剂的敏感性,为科学选择和合理使用消毒剂,提高ICU预防性消毒工作质量提供依据。方法通过最小抑菌浓度试验(MIC),检测环境分离菌株对邻苯二甲醛、含氯消毒剂、碘伏和酒精的敏感性,与标准菌株相比较,判断菌株的消毒剂抗性水平。结果邻苯二甲醛对各试验菌的MIC值除大肠埃希菌与标准菌株一致以外,其他试验菌的MIC值均高于标准菌株;碘伏消毒液对90.0%屎肠球菌的MIC值高于标准菌株;含氯消毒液对革兰氏阴性菌的MIC值显著高于标准菌株;酒精对所有实验菌株的MIC值均与标准菌株一致。结论 ICU环境分离出的菌株已经对临床常用的邻苯二甲醛、含氯消毒液和碘伏消毒液产生不同程度的抗性。
Objective To investigate the levels of disinfectant resistance of pathogens isolated from ICU,provide reference for the scientific use of chemical disinfectants and improving the quality of preventive disinfection.Methods Minimum inhibitory concentration(MIC) method was used to detect the sensitivity of environmental isolates to phthalaldehyde,chlorine-containing disinfectant,iodide and alcohol,we compared with standard strains to determine the level of disinfectant resistance of isolated strains.Results The MIC value of phthalaldehyde to each test bacterium was higher than that of the standard strain except for Escherichia coli.The MIC value of iodophor disinfectant for 90.0% enterococcus faecium was higher than that of standard strain,and that of chlorine disinfectant for Gram-negative bacteria was significantly higher than that of standard strain.MIC values of alcohol for all experimental strains were consistent with those of standard strains.Conclusion ICU environmental isolates have developed varying degrees of resistance to clinical commonly used phthalaldehyde,chlorine-containing disinfectant and iodide disinfectant.
Objective To investigate the levels of disinfectant resistance of pathogens isolated from ICU,provide reference for the scientific use of chemical disinfectants and improving the quality of preventive disinfection.Methods Minimum inhibitory concentration(MIC) method was used to detect the sensitivity of environmental isolates to phthalaldehyde,chlorine-containing disinfectant,iodide and alcohol,we compared with standard strains to determine the level of disinfectant resistance of isolated strains.Results The MIC value of phthalaldehyde to each test bacterium was higher than that of the standard strain except for Escherichia coli.The MIC value of iodophor disinfectant for 90.0% enterococcus faecium was higher than that of standard strain,and that of chlorine disinfectant for Gram-negative bacteria was significantly higher than that of standard strain.MIC values of alcohol for all experimental strains were consistent with those of standard strains.Conclusion ICU environmental isolates have developed varying degrees of resistance to clinical commonly used phthalaldehyde,chlorine-containing disinfectant and iodide disinfectant.
引文
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[2] 李霞,王利平,张珊珊.ICU医院感染的危险因素分析及预防对策[J].中华医院感染学杂志,2014,24(2):367-368,371.
[3] 文细毛,任南,吴安华,等.全国医院感染监测网2012年综合ICU 医院感染现患率调查监测报告[J].中国感染控制杂志,2014,13(8):458-462.
[4] 中国人民共和国卫生部.消毒技术规范[S].北京:中华人民共和国卫生部.2002.
[5] 张弟强,张娟胜,王国庆.细菌对消毒剂抗性机制的研究进展 [J].中国消毒学杂志2017,34(7):675-679.
[6] 胡付品,郭燕,朱德妹,等.2017年 CHINET中国细菌耐药性监测[J].中国感染与化疗杂志,2018,18(3):241-251.
[7] 纪风兵,熊杰,胡章勇,等.成都地区耐甲氧西林金黄色葡萄球菌的qacA基因检测及对常见消毒剂的抗性研究[J].四川医学,2017,38(4):366-369.
[8] 王会平,张洪江,董歧,等.医院环境物体表面及医务人员手分离病原菌对抗菌药物和消毒剂的耐药性[J].中国感染控制杂志,2016,15(12):921-925.
[9] 国家卫生和计划生育委员会.医疗机构环境表面清洁与消毒管理规范[S].北京:国家卫生和计划生育委员会,2016.
[10] 惠云芳,晁青,张亚婷,等.75%乙醇消毒加药口在静脉药物配置中心的应用及效果评价[J].中国继续医学教育,2017,9(11):169-171.
[11] 秦瑾,郭亚萍,冯忠军,等.五种常用皮肤黏膜消毒剂对多重耐药菌杀灭效果观察[J].中国消毒学杂志,2017,34(12):1110-1113.