消毒剂耐药基因 qacEΔ1对新生儿科常见革兰阴性菌耐药性的影响

摘要

Objective To study the effect of disinfectant resistance gene qacEΔ1 on the drug resistance of com-monly isolated gram-negative bacteria.Methods Gram-negative bacteria isolated from neonates in a neonatal inten-sive care unit (NICU)in July-December 2013 were detected and performed antimicrobial susceptibility testing, qacEΔ1 gene were detected by polymerase chain reaction.Results A total of 608 gram-negative bacteria were collected, the major isolates were Klebsiella pneumoniae (n=216),followed by Escherichia coli (n=128),Enterobacter cloacae (n=77),Acinetobacter baumannii (n =62),and Pseudomonas aeruginosa (n =19).The positive rate of qacEΔ1 gene in above five bacteria was 62.75% (315/502),Acinetobacter baumannii was the highest (87.10%).qacEΔ1-positive and negative strains showed statistical difference in the resistance rates to piperacillin,cefepime,aztreonam,imipenem,and compound sulfamethoxazole (all P ≤0.05).The resistance rate of five strains to piperacillin,ceftazidime,cefepime,and az-treonam were all high.Conclusion The positive rates of qacEΔ1 in five major gram-negative bacteria from neonates in NICU are all high,qacEΔ1-positive strains have even higher resistance rates to piperacillin,cefepime,aztreonam,imipen-em,and compound sulfamethoxazole.%目的：研究消毒剂耐药基因 qacEΔ1对常见革兰阴性（G－）菌耐药性的影响。方法对2013年7—12月某院新生儿科住院患儿送检标本分离的 G－菌进行检测和药敏试验，应用聚合酶链反应（PCR）法对其 qacEΔ1基因进行检测。结果共收集608株 G－菌，以肺炎克雷伯菌（216株）居多，其次为大肠埃希菌（128株）、阴沟肠杆菌（77株）、鲍曼不动杆菌（62株）及铜绿假单胞菌（19株）。5种主要细菌 qacEΔ1基因阳性率为62．75％（315／502），其中鲍曼不动杆菌 qacEΔ1基因阳性率最高（87．10％）。主要细菌中，qacEΔ1基因阳性和阴性菌株对哌拉西林、头孢吡肟、氨曲南、亚胺培南、复方磺胺甲口恶唑的耐药率比较，差异有统计学意义（均 P ≤0．05）。5种主要细菌对哌拉西林、头孢他啶、头孢吡肟、氨曲南耐药率均高。结论新生儿病房中分离的 5种主要 G－菌耐消毒剂基因阳性率高，qacEΔ1基因阳性菌株对对哌拉西林、头孢吡肟、氨曲南、亚胺培南、复方磺胺甲口恶唑耐药率更高。