河南省某三甲医院980株碳青霉烯耐药肠杆菌科细菌分布与耐药性分析  

Distribution and drug resistance of 980 strains of carbapenem-resistant Enterobacteriaceae isolates in a third grade A hospital in Henan province

作　　者：张磊[1] 常清利 明朝瑞 王国戗[1] 莫清江[1] 仲华[1] ZHANG Lei;CHANG Qingli;MING Chaorui;WANG Guoqiang;MO Qingjiang;ZHONG Hua(Department of Laboratory,the First Affiliated Hospital of Xinxiang Medical College,Weihui,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院检验科,河南卫辉453100

出　　处：《河南预防医学杂志》2022年第5期362-365,共4页Henan Journal of Preventive Medicine

基　　金：河南省医学科技攻关计划项目(2018020359)。

摘　　要：目的了解河南省某医院碳青霉烯耐药肠杆菌科细菌(CRE)的临床分布特点及其耐药情况。方法采用自动化仪器法或纸片扩散法对该院2015-2019年各临床科室分离出的非重复耐碳青霉烯类肠杆菌科细菌进行药物敏感性测试,药敏结果按2018年临床和实验室标准化协会(CLSI)标准判读,采用WHONET 5.6软件统计分析。结果共检出980株CRE菌株,肺炎克雷伯菌是最常见细菌(680株,69.39%),其次是大肠埃希菌(157株,16.02%)和阴沟肠杆菌(62株,6.33%);CRE菌株标本主要来源和科室分布最多者分别为下呼吸道标本(68.98%)和重症监护室(39.49%)。药敏试验结果显示,CRE菌株对临床常用抗菌药物均具有较高的耐药性,除对阿米卡星、四环素、氯霉素、多粘菌素耐药率较低外(分别为45.31%、41.84%、40.20%和2.55%),对其余16种抗菌药物的耐药率大于60.00%。结论临床分离的CRE菌株对常用抗生素耐药情况严重,在某些科室如重症监护室较为集中,应采取有效的措施进行预防控制,限制其在院内传播流行。Objective To investigate the distribution and antibiotic resistance of carbapenem-resistant Enterobacteriaceae(CRE)isolates in a hospital of Henan.Methods Antimicrobial susceptibility testing was performed on CRE collected from the clinical departments in our hospital from 2015 to 2019,by automated systems or Kirby-Bauer method.The testing results were interpreted according to CLSI 2018 breakpoints and analyzed by WHONET 5.6 software.Results A total of 980 clinical carbapenem-resistant Enterobacteriaceae isolates were collected,Klebsiella pneumoniae was the most frequent(680,69.39%)bacteria followed by Escherichia coli(157,16.02%)and Enterobacter cloacae(62,6.33%)respectively.Of the 980 isolates,68.98%and 39.49%were from respiratory tract and ICU,respectively.The results of antimicrobial susceptibility test showed that the resistance rate of CRE isolates to the other 16 species antimicrobial drugs was greater than 60.00%,except amikacin(45.31%),tetracycline(41.84%),chloramphenicol(40.20%)and polymyxin(2.55%).Conclusions Antimicrobial resistance of CRE isolates was serious,which poses a threat to the clinical treatment of infections.The spread of CRE strains in a specific region such as ICU poses a serious threat to clinical practice and effective measures should be taken to prevent CRE infections and control the spread of such resistant strains in the hospital.

关 键 词：碳青霉烯类耐药肠杆菌科细菌 耐药性监测 药物敏感性实验 感染控制 

分 类 号：R446.5[医药卫生—诊断学]