Abstract：
Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common and difficult pathogens of nosocomial infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests of seven kinds of disinfectants (0.1% benzalkonium bromide, 4% aqueous chlorhexidine, 75% alcohol, entoiodine II, 2% glutaraldehyde, 2000 mg/L chlorine-containing disinfectants, and 3% hydrogen peroxide) were detected by the broth dilution method. Three efflux pump genes (oqxA, oqxB, and qacE∆1-sul1) were detected by PCR. The mean MIC value of aqueous chlorhexidine from the intensive care unit (ICU) (0.0034%) was significantly higher than that from non-ICUs (0.0019%) (p < 0.05). The positive rates of three efflux pump genes oqxA, oqxB and qacE∆1-sul1 were 60.9% (39/64), 17.2% (11/64) and 71.9% (46/64) in the detected CRKP isolates, respectively. This study discovered that CRKP strains demonstrated extensive resistance to clinical disinfectants and suggest that it is necessary to perform corresponding increases in the concentration of aqueous chlorhexidine and chlorine-containing disinfectants on the basis of current standards in the healthcare industry.
摘要：
由于消毒剂的长期和广泛使用,消毒剂的耐药性正在演变为一个严重的问题,这给医院感染控制带来了极大的挑战。作为一种臭名昭著的多重耐药细菌，耐碳青霉烯类肺炎克雷伯菌(CRKP)是医院感染最常见、最困难的病原菌之一。7种消毒剂的最低抑菌浓度(MIC)和最低杀菌浓度(MBC)试验(0.1%苯扎溴铵,4%氯己定水溶液，75%酒精，Ento碘II,2%戊二醛，2000mg/L含氯消毒剂，和3％过氧化氢）通过肉汤稀释法检测。三个外排泵基因(oqxA，OQXB,并通过PCR检测qacEΔ1-sul1)。来自重症监护病房（ICU）的氯己定水溶液的平均MIC值（0.0034％）显着高于非ICU（0.0019％）（p<0.05）。三种外排泵基因oqxA的阳性率，oqxB和qacEΔ1-sul1为60.9%(39/64)，检测到的CRKP分离株分别为17.2%(11/64)和71.9%(46/64),分别。这项研究发现，CRKP菌株表现出对临床消毒剂的广泛抗性，并建议有必要在医疗保健行业的现行标准基础上相应增加氯己定水溶液和含氯消毒剂的浓度。
