耐碳青霉烯类弗劳地枸橼酸杆菌致医院获得性感染的临床特征与耐药性分析  

Analysis on clinical characteristics and drug resistance of Carbapenem resistant Citrobacter freundii in hospital-acquired infections

作　　者：陈建飞 方寅飞 徐浩[2] CHEN Jian-fei;FANG Yin-fei;XU Hao(The Second Hospital of Jinhua,Jinhua Zhejiang 321000;The central Hospital of Jinhua,China)

机构地区：[1]金华市第二医院,浙江金华321000 [2]金华市中心医院

出　　处：《中国消毒学杂志》2022年第4期282-285,共4页Chinese Journal of Disinfection

摘　　要：目的 探讨耐碳青霉烯类弗劳地枸橼酸杆菌(CRCF)致医院获得性感染的临床特征与耐药性。方法 回顾性分析2016年1月—2020年12月某院住院患者临床标本分离CRCF菌株药敏数据及相关临床资料。结果 在2016—2020年间检出的27 486株肠杆菌科细菌中共检出CRCF 39株,检出率为0.14%。不同性别、年龄段、年度、季节、标本类型、临床科室间CRCF的检出率差异有统计学意义(P<0.05)。药敏结果表明,CRCF菌株对临床常用抗菌药物呈高度耐药,对临床广泛使用的含酶抑制剂、三代和四代头孢类、单酰胺环类、碳青霉烯类等抗菌药物100%耐药,对氨基糖苷类药物的耐药率均高于40.00%,对喹诺酮类药物的耐药率均高于55.00%,对多黏菌素B、替加环素全敏感。改良Hodge试验阳性率为79.49%,IMP-EDTA协同试验阳性率为87.18%。结论 该地区CRCF检出率较低,存在严重的多重耐药现象,应对其耐药性进行监测,指导临床合理用药。Objective To explore the clinical characteristics and drug resistance of Carbapenem-resistant Citrobacter freundii(CRCF)in hospital-acquired infections.Methods Retrospective analysis was performed on the drug sensitivity data of CRCF strain isolated from clinical specimens of inpatients in a hospital from January 2016 to December 2020 and relevant clinical data.Results Among 27 486 strains of enterobacteriaceae bacteria detected from 2016 to 2020,a total of 39 strains of CRCF were detected, with the detection rate of 0.14%. The detection rates of sex, age, year, season sample type, clinical department had statistics difference(P<0.05). The drug sensitivity results showed that CRCF strains were highly resistant to clinically common antimicrobial agents, and the drug resistance rate of CRCF strains to enzyme inhibitors, third and fourth generation cephalosporins, monoamide cycloids, carbapenems and other drugs widely used in the clinic were 100.00%. The drug resistance rate of aminoglycoside drugs was higher than 40.00%, and that of quinolones was higher than 55.00%, and all were sensitive to polymyxins B and tegacycline. The positive rate of improved Hodge test and IMP-EDTA co-test were 79.49% and 87.18%, respectively.Conclusion The detection rate of CRCF in this region is low, but with multiple drug resistance. The drug resistance should be monitored to guide the rational clinical use of CRCF so as to prevent the epidemic and spread of CRC.

关 键 词：医院感染 耐碳青霉烯类弗劳地枸橼酸杆菌 临床特征 耐药性 

分 类 号：R181[医药卫生—流行病学]