阴沟肠杆菌耐药性及其感染多重耐药阴沟肠杆菌危险因素的分析  

Study on drug resistance of enterobacter cloacae and risk factors of infection with multi-drug resistant enterobacter cloacae

作　　者：卜丹霞[1] 杨春超[2] 冯慧雅 黄云平[1] 蒋思斯 BU Dan-xia;YANG Chun-chao;FENG Hui-ya;HUANG Yun-ping;JIANG Si-si(Department of Laboratory Medicine,the Central People’s Hospital of Zhanjiang,Zhanjiang 524045,China;Emergency Department,the Central People’s Hospital of Zhanjiang,Zhanjiang 524045,China)

机构地区：[1]湛江中心人民医院检验科,广东湛江524045 [2]湛江中心人民医院急诊科,广东湛江524045

出　　处：《广东医科大学学报》2023年第1期28-31,共4页Journal of Guangdong Medical University

基　　金：广东省医学科学技术研究基金项目(A2021207)。

摘　　要：目的 探讨阴沟肠杆菌的耐药性及感染多重耐药阴沟肠杆菌的危险因素。方法 采用全自动微生物分析仪测定192株非重复阴沟肠杆菌的药物敏感性。运用多因素logistic回归分析多重耐药阴沟肠杆菌感染的危险因素。结果多重耐药阴沟肠杆菌和耐药阴沟肠杆菌的构成比分别为34.4%(66株)和65.6%(126株)。头孢他啶、左氧氟沙星、复方新诺明、阿米卡星、四环素、氯霉素、多粘菌素在多重耐药阴沟肠杆菌组中的耐药率均明显高于耐药阴沟肠杆菌组(均P<0.05或0.01)。logistic回归分析显示,入院APACHEⅡ评分≥20分、入住ICU≥7 d、使用抗生素≥7 d、侵入性操作的P值均<0.01。结论 阴沟肠杆菌的耐药形势严峻,多重耐药阴沟肠杆菌更是不容乐观。入院APACHEⅡ评分≥20分、入住ICU≥7 d、使用抗生素≥7 d、侵入性操作是多重耐药阴沟肠杆菌的独立危险因素。Objective To investigate the drug resistance of enterobacter cloacae and risk factors of infection with multi-drug resistant enterobacter cloacae. Methods The drug sensitivity of 192 non-repetitive enterobacter cloacae strains was determined by an automatic microbiological analyzer. was used to analyze the risk factors of infection with multi-drug resistant enterobacter cloacae was analyzed with multivariate logistic regression method. Results The constituent ratios of multi-drug resistant enterobacter cloacae and drug-resistant enterobacter cloacae were 34.4%(66 strains) and 65.6%(126strains), respectively. The drug resistance rates of enterobacter cloacae to ceftazidime, levofloxacin, cotrimoxazole, amikacin,tetracycline, chloramphenicol and polymyxin in the Multi-Drug Resistant Enterobacter Cloacae Group were significantly higher than those in the Drug Resistant Enterobacter Cloacae Group(P<0.05 or 0.01). logistic regression analysis showed that P values of APACHE II score at admission≥20 points, ICU stay≥7 days, use of antibiotics≥7 days and invasive operation were all <0.01. Conclusion The situation of drug resistance of enterobacter cloacae is serious, and that of multi-drug resistant enterobacter cloacae is even less optimistic. APACHE II score at admission≥20 points, ICU stay≥7 days, use of antibiotics≥7days and invasive operation are independent risk factors of infection with multi-drug resistant enterobacter cloacae.

关 键 词：阴沟肠杆菌 耐药性 危险因素 

分 类 号：R915[医药卫生—微生物与生化药学]