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目的了解医院不同来源金黄色葡萄球菌对常用消毒剂抗力及相关基因的携带状况,为有效控制医院感染提供科学依据。方法用PCR基因扩增技术和纸片扩散法,对上海市某区部分医院临床分离的金黄色葡萄球菌对消毒剂抗力及qac A耐消毒剂基因等进行检测。结果该区的医院临床分离的金黄色葡萄球菌中,qac A基因检出率9.80%,PVL基因检出率为21.57%。医护人员手上分离的金黄色葡萄球菌qac A基因检出率为41.67%,居首位。耐甲氧西林金黄色葡萄球菌qac A基因检出率明显高于敏感菌株。环境物体表面分离的金黄色葡萄球菌在有效氯浓度250 mg/L消毒液中存活率高达64.00%,医护人员手分离菌株在浓度为300 mg/L季铵盐类消毒液中存活率最高为58.33%。结论医院医务人员手上分离的金黄色葡萄球菌qac A携带率最高,物体表面和医务人员手上携带的金黄色葡萄球菌分别对含氯消毒液和季铵盐类消毒液有一定耐受力。
Objective To understand the resistance of different sources of Staphylococcus aureus to the commonly used disinfectants and related genes in hospitals, so as to provide a scientific basis for effective control of nosocomial infections. Methods Using PCR amplification and disk diffusion method, the clinical isolates of Staphylococcus aureus in some hospitals in a certain district of Shanghai were tested for their resistance to disinfectants and qac A-resistant disinfectants. Results In the clinically isolated Staphylococcus aureus in the district, the detection rate of qac A gene was 9.80% and the PVL gene detection rate was 21.57%. The detection rate of qac A gene of Staphylococcus aureus isolated by medical staff was 41.67%, ranking the first place. Methicillin-resistant Staphylococcus aureus qac A gene detection rate was significantly higher than the sensitive strains. Survival rate of Staphylococcus aureus isolated from the surface of environmental objects was as high as 64.00% in the effective chlorine concentration of 250 mg / L disinfectant. The highest survival rate of quarantine bacteria in the quarantine liquid with the concentration of 300 mg / L was 58.33 %. CONCLUSION: The qac A carrier rate of Staphylococcus aureus isolated from the hands of hospital medical staff is the highest, while the Staphylococcus aureus carried on the surface of the object and the staff of medical staff have a certain tolerance to chlorine disinfectant and quaternary ammonium disinfectant respectively.