2017-2019年某院耐碳青霉烯肠杆菌临床分布及耐药性  

Clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae in a hospital from 2017 to 2019

作　　者：胡丽庆[1] 孙定河[1] 王盛 褚金国[1] HU Li-qing;SUN Ding-he;WANG Sheng;CHU Jin-guo(Ningbo First Hospital,Ningbo Zhejiang 315000,China)

机构地区：[1]浙江省宁波市第一医院,浙江宁波315000

出　　处：《中国消毒学杂志》2020年第9期683-685,共3页Chinese Journal of Disinfection

基　　金：浙江省医药卫生科技项目(2019KY164)。

摘　　要：目的了解宁波市第一医院耐碳青霉烯肠杆菌科细菌的临床分布特征及其耐药状况,为医院控制感染、合理选用抗菌药物进行经验性治疗提供参考依据。方法收集2017-2019年该院临床分离的所有肠杆菌科细菌数据资料,采用WHONET 5.6进行回顾性统计分析。结果3年间临床分离肠杆菌科细菌总计7397株,其中耐碳青霉烯类583株,占7.88%。主要分布于重症监护病房237株(40.65%)、急诊病房39株(6.69%)、神经外科病房31株(5.32%)等。排名前5位为肺炎克雷伯菌349株、大肠埃希菌72株、阴沟肠杆菌49株、粘质沙雷菌34株、产气肠杆菌31株。标本主要分离自痰液315株(54.03%)、尿液119株(20.41%)、血液60株(10.29%)。耐药率最高的药物为头孢菌素(头孢曲松、头孢吡肟),其次为酶抑制剂(阿莫西林/克拉维酸、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦),耐药率最低的是替加环素。结论该院耐碳青霉烯类肠杆菌科细菌以肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌为主。碳青霉烯类耐药问题日趋严重,应加强细菌耐药监测管理力度,指导临床合理使用抗菌药物。Objective To understand the clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae(CRE)in Ningbo First Hospital,so as to provide reference for hospital infection control and rational use of antibiotics in empirical treatment.Methods The clinical data of Enterobacteriaceae in our hospital from 2017 to 2019 were collected and analyzed retrospectively by Whonet 5.6.Results A total of 7397 strains of Enterobacteriaceae were clinically isolated in three years,of which 583 strains were resistant to carbapenems,accounting for 7.88%.Most isolates were distributed in ICU(237,40.65%),emergency ward(39,6.69%),neurosurgery ward(31,5.32%),et al.The top five were 349 strains of Klebsiella pneumonia,72 strains of Escherichia coli,49 strains of Enterobacter cloacae,34 strains of Serratia marcescens,31 strains of Enterobacter aerogenes.The specimens were mainly isolated from sputum specimen(315,54.03%),urine(119,20.41%),blood(60,10.29%).The drug with the highest resistant rate was cephalosporin(ceftriaxone,cefepime),followed by Enzyme inhibitors(amoxicillin/clavulanate,cefoperazone/sulbactam,piperacillin/tazobactam),and the lowest resistance rate was tigecycline.Conclusion The main CRE in our hospital are Klebsiella pneumonia,Escherichia coli and Enterobacter cloacae.The problem of carbapenem resistance is becoming more and more serious.The monitoring and management of bacterial resistance should be strengthened,and the clinical rational use of antibiotics should be guided.

关 键 词：耐碳青霉烯类 肠杆菌科细菌 抗菌药物 回顾性分析 

分 类 号：R446.5[医药卫生—诊断学]