某院产科2019~2022年产超广谱β-内酰胺酶肠杆菌的分布及耐药性分析  

The Distribution and Drug Resistance Analysis of Extended-Spectrumβ-lactamase-producing Enterobacter in ObstetricsDepartment of a Hospital from 2019 to 2022

作　　者：高阳[1] 杨冬梅[1] 李幽然 寇晨[2] GAO Yang;YANG Dongmei;LI Youran;KOU Chen(Department of Laboratory Medicine,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China;Department of Neonatology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院检验科,北京100026 [2]首都医科大学附属北京妇产医院/北京妇幼保健院新生儿科,北京100026

出　　处：《标记免疫分析与临床》2023年第11期1842-1845,1929,共5页Labeled Immunoassays and Clinical Medicine

基　　金：首都医科大学附属北京妇产医院青年基金课题(编号:FCYYQN-202102)。

摘　　要：目的产超广谱β-内酰胺酶肠杆菌(extended spectrumβ-lactamases-producing Enterobacter)已成为临床常见的耐药菌之一,在产科领域中引起了广泛关注。本研究旨在调查某院产科2019~2022年间产超广谱β-内酰胺酶(extended spectrumβ-lactamase,ESBLs)肠杆菌的分布情况,并对其耐药性进行分析。方法收集某院产科2019~2022年间的临床样本数据,包括血液、尿液和分泌物等。通过常规细菌培养和鉴定方法,筛选出产ESBLs肠杆菌的菌株。采用梅里埃VITEK MS质谱仪及梅里埃VITEK 2 COMPACT仪器进行菌株鉴定,并进行药敏试验,评估耐药性。结果产科共筛选出152株产ESBLs肠杆菌菌株。这些菌株主要来源于产科患者的胎盘子母面以及伤口分泌物等样本。其中以产ESBLs大肠埃希菌为主,产ESBLs肺炎克雷伯菌次之。在β-内酰胺类抗生素中,59.9%的菌株对头孢菌素类药物显示耐药性,35.5%对类β-内酰胺酶抑制剂联合药物耐药,但是对碳青霉烯类抗生素耐药率仅为0.01%;在氟喹诺酮类抗生素中,73.4%的菌株对氟喹诺酮类药物表现出耐药性;在氨基糖苷类抗生素中,21.5%的菌株对氨基糖苷类药物耐药;在磺胺类抗生素中,53.9%的菌株对磺胺类药物耐药。结论某院产科2019~2022年产ESBLs肠杆菌的分布较为广泛,且这些菌株普遍存在耐药性。针对这种情况,临床医生应谨慎选择抗生素治疗方案,加强感染控制措施,并进行合理的药物使用与监测,以减少产ESBLs肠杆菌感染的发生和传播。Objective ESBLs-producing Enterobacter has become one of the most common antibiotic-resistant bacteria in clinical practice and has attracted wide attentions in the field of obstetrics.The purpose of this study was to investigate the distribution of extended spectrumβ-lactamase-producing Enterobacter in Obstetrics Department of a hospital from 2019 to 2022,and to analyze its drug resistance.Methods Clinical samples,including blood,urine and secretion,were collected from 2019 to 2022 in Obstetrics Department of a hospital.Through routine bacterial culture and identification methods,strains of ESBLs-producing Enterobacter were screened.These strains were identified by Meria VITEK MS mass spectrometer and Meria VITEK 2 COMPACT instrument,and drug susceptibility test was carried out to evaluate drug resistance.Results A total of 152 strains of ESBLs-producing Enterobacter were identified in obstetrics.These strains were mainly from placental mother face and wound secretion samples of obstetric patients.Among them,ESBLs-producing Escherichia coli was the main one,followed by ESBLs-producing Klebsiella pneumoniae.Among beta-lactam antibiotics,59.9%strains showed resistance to cephalosporins and 35.5%to beta-lactamase-like inhibitors,but the resistance rate to carbapenem antibiotics was only 0.01%.Among fluoroquinolones,73.4%strains showed drug resistance to fluoroquinolones.Among aminoglycoside antibiotics,21.5%strains were resistant to aminoglycoside drugs.Among sulfonamides,53.9%strains were resistant to sulfonamides.Conclusion ESBLs-producing Enterobacter strains are widely distributed in Obstetrics Department of a hospital from 2019 to 2022,and these strains are generally resistant to drugs.In view of this situation,clinicians should carefully choose antibiotic treatment schemes,strengthen infection control measures,and carry out reasonable drug use and monitoring steps to reduce the occurrence and spread of ESBLs-producing Enterobacter infection.

关 键 词：超广谱β内酰胺酶肠杆菌 产科 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]