Evaluation of Resistance by Clinically Pathogenic Bacteria to Antimicrobials and Common Disinfectants in Beijing, China
Evaluation of Resistance by Clinically Pathogenic Bacteria to Antimicrobials and Common Disinfectants in Beijing, China
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DOI：
10.1272/jnms.jnms.2018_85-49
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发表时间：
2018-12-01
影响因子：
1
通讯作者：
Guo, Wei
中科院分区：
文献类型：
--
作者：
Shan, Kai;Li, Jianguo;Guo, Wei
背景：病原菌的抗生素耐药性在临床医生中得到了很好的认识，但在临床环境中直接评估细菌对常用消毒剂的耐药性的研究还很少。目前已有的报道主要集中在单一菌株对单一消毒剂的耐药性上，而对大规模临床使用消毒剂时对抗菌素的耐药程度和交叉耐药性研究不够。方法：对北京市10家医院、中国等10家医院1年来采集的患者体液细菌对11种抗生素和7种化学消毒剂的耐药性进行调查。结果：共鉴定致病菌1104株，其中革兰氏阳性菌占23%，革兰氏阴性菌占74%，真菌占3%。总体而言，最常见菌株对抗生素的抵抗力明显高于对消毒剂的抵抗力。最无效的抗生素和消毒剂分别是氨曲南和戊二醛，总体耐药率最高；阿米卡星和酒精的耐药率最低。鲍曼不动杆菌对抗生素和消毒剂的耐药率最高，而大肠埃希菌对抗生素和消毒剂的耐药率最低。结论：根据本次调查的细菌感染性病原菌的病原菌谱，以及他们对抗菌药物和常见临床消毒剂的耐药性现状，医护人员不仅要重视抗菌药物的规范使用，而且要重视消毒剂的合理使用。
Background: Antibiotic resistance of pathogenic bacteria is well recognized among clinicians; however, studies that directly evaluate the bacterial resistance to commonly used disinfectants in clinical settings are lacking. Currently available reports focus on the resistance of single strains to single disinfectants and do not adequately examine the degree of resistance and cross-resistance to antimicrobials in the large-scale clinical use of disinfectants.Methods: We investigated the resistance capacity to 11 antibiotics and 7 chemical disinfectants by bacterial strains collected from body fluids of patients in 10 hospitals in Beijing, China over a 1-year period. Bacterial resistance to disinfectants was tested using minimum inhibitory concentration and minimum bactericidal concentration using agar dilution methods based on commercially available reference strains.Results: A total of 1,104 pathogenic strains were identified, of which 23% were Gram-positive bacteria, 74% were Gram-negative bacteria, and 3% were fungi. Overall, resistance to antibiotics for the most common strains was significantly higher than their resistance to disinfectants. The least effective antibiotics and disinfectants were aztreonam and glutaral, respectively, exhibiting the highest overall resistance rates; while amikacin and alcohol had the lowest resistance rates. Consistently, Acinetobacter baumannii exhibited the most resistance, while Escherichia coli had the least resistance for both antibiotics and disinfectants.Conclusions: Based on the pathogen spectrum for bacterial infective pathogens evaluated in this study, as well as the status quo of their resistance to antimicrobial agents and common clinical disinfectants, it is essential for healthcare professionals to pay attention not only to the standardized use of antimicrobial agents but also to the rational application of disinfectants.