耐碳青霉烯类肠杆菌科细菌的分布特点及耐药性分析  

Distribution characteristics and drug resistance analysis of carbapenem-resistant Enterobacteriaceae

作　　者：喻长法[1] 叶丽君[1] 辛栋轶 YU Chang-fa;YE Li-jun;XIN Dong-yi(Taizhou First People's Hospital,Taizhou Zhejiang 318020,China)

机构地区：[1]台州市第一人民医院,浙江台州318020

出　　处：《中国消毒学杂志》2022年第1期55-57,61,共4页Chinese Journal of Disinfection

基　　金：台州市科技计划项目(1601KY29)。

摘　　要：目的探讨耐碳青霉烯类肠杆菌科细菌(CRE)的分布特点及耐药性,为临床合理用药提供依据。方法采用回顾性方法对2017年1月—2020年12月检测到的280株CRE临床分布特点及药物敏感性进行系统性分析。结果随着年龄的增大,CRE检出菌株数量也随之增加;CRE检出率从2017年的3.83%提高到2020年的5.13%,呈逐年上升趋势。CRE菌株以肺炎克雷伯菌、阴沟肠杆菌、大肠埃希菌和黏质沙雷菌为主;CRE菌株主要来源于痰液、尿液、分泌物和血液标本;CRE菌株分布以重症监护病房、呼吸内科、肿瘤科和老年病科为主。肺炎克雷伯菌对阿米卡星、妥布霉素、替加环素的耐药率较低,对其余抗菌药物的耐药率较高;阴沟肠杆菌、大肠埃希菌和黏质沙雷菌对阿米卡星、妥布霉素、哌拉西林/他唑巴坦、庆大霉素、头孢哌酮/舒巴坦、替加环素的耐药率较低。结论CRE菌株临床分布广泛,对常用的抗菌药物耐药率普遍较高,应加强抗菌药物合理使用,注重医院感染的预防和监测。Objective To investigate the distribution characteristics and drug resistance of carbapenem-resistant Enterobacteriaceae(CRE),and to provide a basis for clinical rational use of drugs.Methods A retrospective method was used to systematically analyze the clinical distribution characteristics and drug sensitivity of 280 CRE strains detected from January 2017 to December 2020.Results With the increase of age,the number of CRE strains detected also increased;the detection rate of CRE increased from 3.83%in 2017 to 5.13%in 2020,showing an upward trend year by year.CRE strains were mainly Klebsiella pneumoniae,Enterobacter cloacae,Escherichia coli and Serratia marcescens;CRE strains were mainly derived from sputum,urine,secretions and blood samples;CRE strains were mainly distributed in intensive care unit and departments of respiratory medicine,oncology and geriatrics.Klebsiella pneumoniae had a low resistance rate to amikacin,tobramycin and tigecycline,and had a high resistance rate to other antibacterial drugs;the resistance rates of Enterobacter cloacae,Escherichia coli and Serratia marcescens to amikacin,tobramycin,piperacillin/tazobactam,gentamicin,cefoperazone/sulbactam,tigacycline was low.Conclusion CRE strains are widely distributed in clinic,and the resistance rate to commonly used antibacterial drugs is generally high.The rational use of antibacterial drugs should be strengthened,and the prevention and monitoring of nosocomial infection should be emphasized.

关 键 词：耐碳青霉烯类肠杆菌科细菌 分布 耐药性 

分 类 号：R372[医药卫生—病原生物学]