159株耐碳青霉烯类肠杆菌科细菌的临床特征和耐药性分析  

Analysis on clinical characteristics and drug resistance in 159 strains of carbapenem-resistant Enterobacteriaceae bacteria

作　　者：张慧[1] 王健[2] 吴晓燕[1] 张金业[1] 刘继斌[3] 林兰[1] ZHANG Hui;WANG Jian;WU Xiaoyan;ZHANG Jinye;LIU Jibin;LIN Lan(Department of Clinical Laboratory,Nantong Municipal Tumor Hospital,Nantong,Jiangsu 226000,China;Department of Clinical Laboratory,Nantong MunicipalThird People′s Hospital,Nantong,Jiangsu 226000,China;Scientific Research Institute,NantongMunicipal Tumor Hospital,Nantong,Jiangsu 226000,China)

机构地区：[1]江苏省南通市肿瘤医院检验科,226000 [2]江苏省南通市第三人民医院检验科,226000 [3]江苏省南通市肿瘤医院科研所,226000

出　　处：《检验医学与临床》2018年第20期3050-3052,3055,共4页Laboratory Medicine and Clinic

摘　　要：目的分析耐碳青霉烯类肠杆菌科细菌(CRE)的临床分布特征及耐药性,为指导临床合理用药提供依据。方法收集2014年7月至2017年6月南通市肿瘤医院和南通市第三人民医院临床标本中分离的CRE,采用VITEK2Compact全自动微生物分析系统对上述菌株进行鉴定,K-B纸片扩散法对亚胺培南进行复核,改良Hodge试验确认CRE的产酶情况,并对结果进行分析。结果共收集CRE 159株,主要是肺炎克雷伯菌肺炎亚种(132株)和大肠埃希菌(22株);47.80%来源于呼吸道痰液标本,23.90%来源于尿液标本;66.67%的标本分布在重症监护室,其次是肿瘤科,占16.35%。药敏结果显示CRE除了对阿米卡星耐药率较低(23.90%),对其他抗菌药物均表现出较高的耐药率,均>70.00%。结论 CRE高耐药性比较明显,并且其临床分布及标本来源较为广泛,应加强抗菌药物的管理和合理使用,加强医院感染的预防和控制,避免医院内感染的暴发流行。Objective To analyze the clinical distribution characteristics and drug resistance in 159 strains of carbapenem-resistant Enterobacteriaceae （CRE） bacteria in order to provide a basis for clinical rational drug use. Methods The CRE strains isolated from the clinical samples in the Nantong Municipal Tumor Hospital and Nantong Municipal Tumor Hospital from July 2014 to June 2017 were collected and identified by using the VITEK-2 campact full-automatic microorganism analysis system.The Kirby-Bauer method was used to conduct the re-examination on imipenem.The CRE producing enzyme situation was verified by using the modified Hodge test （MHT）.The the results were analyzed. Results A total of 159 strains of CRE were collected,which were mainly Klebsiella pneumoniae（132 strains） and Escherichia coli （22 strains）;47.80% were derived from the respiratory tract sputum samples,23.90% were derived from the urinary samples;66.67% of samples were distributed in the ICU,followed by the oncology department,accounting for 16.35%.The drug susceptibility test results showed that CRE had lower resistance rate to amikacin （23.90%）,and had higher resistance to other antibacterial drugs （〉70.00%）. Conclusion The higher drug resistance of CRE is obvious,its clinical distribution and sample sources are abroad.Therefore the management and rational use of antibacterial drugs should be strengthened,the prevention and control of nosocomial infection should be strengthened to avoid the outbreak of nosocomial infections.

关 键 词：耐碳青霉烯类肠杆菌科细菌 药敏试验 耐药性 

分 类 号：R378.8[医药卫生—病原生物学]