近5年耐碳青霉烯类肠杆菌科细菌流行病学及耐药性分析  

Analysis of clinical epidemiology and antibiotic resistance of carbapenem-resistant Enterobacteriaceae in recent 5 years

作　　者：曾晓艳[1] 李芳[1] 雷金娥[1] 陈葳[1] 王军阳 ZENG Xiaoyan;LI Fang;LEI Jin′e;CHEN Wei;WANG Junyang(Department of Clinical Laboratory,the First Affiliated Hospital,Xi′an Jiaotong University,Xi′an 710061,China;Department of Immunology and Pathogenic Biology,Xi′an Jiaotong University Health Science Center,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院检验科,西安710061 [2]西安交通大学医学部病原生物学与免疫学系,西安710061

出　　处：《西北药学杂志》2019年第5期684-689,共6页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金项目(编号:81201326);陕西省重点研发计划项目(编号:2017SF-170)

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情况,为临床合理应用抗菌药物及医院感染控制提供依据。方法对该院2013年1月~2017年12月住院及门诊患者临床标本进行培养、鉴定和药敏试验,对结果进行统计学处理。结果肠杆菌科20 061株细菌共检出CRE 404株(2.0%),其中108株为肺炎克雷伯菌(46.0%);主要分离自痰液、尿液和引流液。药敏结果显示,CRE菌株对阿米卡星、复方新诺明、妥布霉素和庆大霉素的耐药率分别为38.4%,60.9%,74.0%和74.9%,对其他14种抗菌药物的耐药率均高于80%。结论CRE菌株的检出率呈逐年上升趋势,菌种以肺炎克雷伯菌为主,并对多种临床常用抗菌药物呈高度耐药。建议今后应做好医院感染监测,合理使用抗菌药物,预防和控制耐药菌株的产生和传播。Objective To provide the basis for rational use of antimicrobial agents in clinic,we investigated the distribution and antibiotic resistance of carbapenem-resistant Enterobacteriaceae(CRE).Methods The clinical infection specimens of inpatients and outpatients in our hospital from January 2013 to December 2017 were cultured and identified by routine methods.The antibiotic susceptibility was tested and the results were statistically treated.Results A total of 404 CRE strains(2.0%)were isolated in 20 061 Enterobacteriaceae isolates in recent 5 years.108 of them were Klebsiella pneumoniae(46.0%),which were from sputum,urine and drainage liquid.Antibiotic sensitivity test results showed that the resistance rates of CRE to amikacin,cotrimoxazole,gentamicin and tobramycin were 38.4%,60.9%,74.0%and 74.9%,respectively.The resistant rates to other 14 kinds of antibiotics were almost more than 80%.Conclusion The strain of CRE was increasing year by year,in which carbapenem-resistant Klebsiella pneumoniae was the main isolates,and it is highly resistant to many commonly used antibiotics.It is necessary to monitor nosocomial infection and use antibiotics rationally so as to effectively prevent and control the emergence and spread of drug-resistant strains.

关 键 词：抗菌药物 耐碳青霉烯类肠杆菌科细菌 流行病学 耐药性 

分 类 号：R969.3[医药卫生—药理学]