119株摩根摩根菌临床分布及耐药性变迁  

Clinical distribution and change of drug resistance of 119 Morganella morganii isolates

作　　者：张丽伟[1] 王玉月[2] 冯诚怿 王伟伟 狄佳[1] 江淑芳[1] ZHANG Li-wei;WANG Yu-yue;FENG Cheng-yi;WANG Wei-wei;DI Jia;JIANG Shu-fang(The First People's Hospital of Changzhou,Changzhou,Jiangsu 213003,China)

机构地区：[1]常州市第一人民医院感染管理处,江苏常州213003 [2]常州市第一人民医院医学检验科,江苏常州213003

出　　处：《中华医院感染学杂志》2024年第5期663-667,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年基金资助项目(81502002);常州市卫健委青年人才科技基金资助项目(QN202019)。

摘　　要：目的 分析119株摩根摩根菌临床分布及耐药性变迁。方法 通过实验室信息管理系统和杏林医院感染实时监测系统收集常州市第一人民医院2019年9月-2022年9月临床分离的119株摩根摩根菌的临床分布、标本来源、感染状态及部位、药敏结果与耐药性变迁。结果 119株菌株主要分布在重症医学科、泌尿外科及肾内科;标本来源主要为尿液、脓液及痰液;其中医院感染22株、社区感染55株,医院感染部位以下呼吸道和菌血症为主,社区感染部位以泌尿道和皮肤软组织为主,二者分布完全不同(P<0.05);119株菌株中耐碳青霉烯类肠杆菌(CRE)比例占19.33%,多重耐药菌(MDRO)占31.93%;摩根摩根菌对青霉素类、喹诺酮类、头孢类等药物三年间耐药性比较,无统计学差异,但是对碳青霉烯类中亚胺培南三年间耐药性差异有统计学意义,且随年份增加而增加(P<0.05)。结论 摩根摩根菌可引起多种感染,社区感染比例高于医院感染,医院感染仍以下呼吸道为主。阿米卡星等可作为临床治疗摩根菌感染的一线用药,耐碳青霉烯类的摩根菌检出率逐年升高,临床应根据药敏结果合理用药,并对其耐药性加强监测。OBJECTIVE To investigate the clinical distribution and change of drug resistance of 119 isolates of Mor-ganella morganii.METHODS The clinical distribution,specimen sources,infection state,infection sites,results of drug susceptibility testing and changes of drug resistance of the 119 isolates of M.morganii were collected from the First People's Hospital of Changzhou by means of laboratory information management system and Xinglin Hospital Infection Real-time Monitoring System from Sep 2019 to Sep 2022.RESULTS The 119 isolates were mainly isolated from critical care medicine department,urinary surgery department and nephrology department.Urine,pus and sputum specimens were the major specimen sources.There were 22 strains of nosocomial infection and 55 strains of community-associated infection.Lower respiratory tract and bacteriemia were the major nosoco-mial infection sites;the urinary tract and skin soft tissue were the major community-associated infection sites;there was significant difference in the distribution between the types of infection sites(P<0.05).Among the 119 isolates of M.morganii,carbapenem-resistant Enterobacter(CRE)accounted for 19.33%,and multidrug-resist-ant organisms(MDROs)accounted for 31.93%.There was no significant difference in the drug resistance of M.morganii isolates to penicillins,quinolones and cephalosporins among the three years,but there was significant difference in the drug resistance to imipenem of the carbapenems among the three years,and the drug resistance was increased with the years(P<0.05).CONCLUSION The M.morganii may result in a variety of infections,the proportion of community-associated infection is higher than that of the nosocomial infection.The lower respiratory tract is the major nosocomial infection site.Amikacin can be used as the frontline drug for the clinical treatment of M.morganii infection.The isolation rate of carbapenem-resistant Morganella isolates is increased year by year.It is necessary for the hospital to reasonably use antibiotics based on the resul

关 键 词：摩根摩根菌 临床分布 标本来源 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]