耐碳青霉烯类肠杆菌科细菌的分布特点与耐药性分析  

Distribution and drug resistance of carbapenem-resistant Enterobacteriaceaeisolates

作　　者：张艳君[1] 秦琴[2] 李虎[2] 马秀珍[1] 陈志强[1] 邓安梅[2] 黄怡[1] 

机构地区：[1]解放军第二军医大学附属上海长海医院感染控制科,上海200433 [2]解放军第二军医大学附属上海长海医院实验诊断科,上海200433

出　　处：《中华医院感染学杂志》2016年第2期245-247,共3页Chinese Journal of Nosocomiology

基　　金："十二五"国家科技重大专项基金资助项目(2013ZX10003009)

摘　　要：目的了解2013-2014年耐碳青霉烯类肠杆菌科细菌(CRE)的分布特点及其耐药性,为指导临床合理用药提供依据。方法收集2013年1月-2014年12月临床分离CRE,采用自动化仪器方法和纸片扩散法(K-B法)对上述菌株进行药物敏感性试验,药敏结果严格按照美国临床实验室标准化研究所(CLSI)或FDA标准进行判定;采用WHONET软件对数据进行统计分析。结果共收集临床分离CRE 538株,主要包括肺炎克雷伯菌222株占41.3%、大肠埃希菌72株占13.4%;CRE主要标本来源为呼吸道,共181株占33.6%;CRE除对阿米卡星和替加环素耐药率较低外,对其他抗菌药物的耐药率均>40.0%。结论 CRE对多数常用抗菌药物呈现耐药,给临床抗感染治疗带来严峻挑战,应加强对CRE的耐药性监测,并采取有效措施预防和控制此类耐药菌的传播。OBJECTIVE To understand the distribution and drug resistance of carbapenem-resistant Enterobacteriaceaeisolates from 2013 to 2014so as to provide guidance for reasonable clinical use of antibiotics.METHODS From Jan 2013 to Dec 2014,the clinical carbapenem-resistant Enterobacteriaceaeisolates were collected,then the drug susceptibility testing for the strains was carried out by using automated instrument method and disk diffusion method（K-B method）,the results of the drug susceptibility testing were interpreted according to the standards of Clinical Laboratory Standards Institute（CLSI）or FDA,and the statistical analysis of data was performed with the use of WHONET software.RESULTS A total of 538 clinical carbapenem-resistant Enterobacteriaceae isolates were collected,including 222（41.3%）strains of Klebsiella pneumoniae and 72（13.4%）strains of Escherichia coli.Totally 181 strains of carbapenem-resistant Enterobacteriaceae were isolated from the specimens obtained from respiratory tracts,accounting for 33.6%.The drug resistance rate of the carbapenem-resistant Enterobacteriaceae strains to all the antibiotics was more than 40.0% except for amikacin and tigecycline.CONCLUSIONThe carbapenem-resistant Enterobacteriaceaeisolates are resistant to most of the commonly used antibiotics,which poses a threat to the clinical treatment of infections.It is necessary to strengthen the surveillance of drug resistance of the carbapenem-resistant Enterobacteriaceaeisolates and take effective prevention measures so as to control the spread of the drug-resistant strains.

关 键 词：耐药性监测 药物敏感性 耐碳青霉烯类 肠杆菌科细菌 感染控制 

分 类 号：R378.2[医药卫生—病原生物学]