154株枸橼酸杆菌的临床分布及耐药性分析  

Clinical distribution and drug resistance analysis of 154 strains of Citrobacter

作　　者：屠友权[1] 陈群英[1] 韩清 TU You-quan;CHEN Qun-ying;HAN Qing(Ningbo Women and Children's Hospital,Ningbo Zhejiang 315012,China)

机构地区：[1]宁波市妇女儿童医院,浙江宁波315012

出　　处：《中国消毒学杂志》2024年第4期261-263,共3页Chinese Journal of Disinfection

摘　　要：目的了解枸橼酸杆菌在医院感染中的临床分布及耐药性。方法采用VITEK 2全自动微生物分析仪和配套的GNI、GNS-13,对2013年1月—2022年12月分离的枸橼酸杆菌进行鉴定和药敏试验,药敏结果使用Whonet 5.6软件进行分析。结果共分离到154株枸橼酸杆菌,主要来自尿液标本(53.25%),其次是脓液/切口(16.88%)。其中,弗氏枸橼酸杆菌最多,占49.35%;其次是克氏枸橼酸杆菌,占33.12%。枸橼酸杆菌对头孢唑啉耐药率在97.8%~100.0%,对碳青霉烯类的耐药率均为0.0%,对三代或四代头孢菌素、头孢替坦、氨曲南、庆大霉素、妥布霉素和哇诺酮类的耐药率均小于15.8%,对哌拉西林/他唑巴坦和呋喃妥因耐药率均小于1.7%,对复方新诺明的耐药率在11.8%~40.8%。结论枸橼酸杆菌耐药机制复杂,临床应以药敏结果为指导,哌拉西林/他唑巴坦和呋喃妥因可作为首选药物。Objective To investigate the clinical distribution and drug resistance of Citrobacter in nosocomial infection.Methods VITEK 2 automatic microbiological analyzer and GNI and GNS-13 were used to identify Citrobacter isolated from January 2013 to December 2022 and to conduct drug susceptibility tests.The results were analyzed using WHONET5.6 software.Results A total of 154 strains of Citrobacter were isolated,mainly from urine samples(53.25%),followed by pus/incision(16.88%).Among them,Citrobacter freundii was the most,accounting for 49.35%,followed by Citrobacter kirschi,accounting for 33.12%.The resistance rate of Citrobacter to cefazolin ranged from 97.8%to 100%,and the resistance rate to carbapenems was 0.0%.The resistance rate to third-generation or fourth-generation cephalosporins,cefotetan,aztreonam,gentamicin,tobramycin and quinolones were all less than 15.8%,and the resistance rate to piperacillin/tazobactam and nitrofurantoin were less than 1.7%.The resistance rate to co-trimoxazole was between 11.8%and 40.8%.Conclusion The drug resistance mechanism of Citrobacter is complex,and clinical practice should be guided by drug susceptibility results.Piperacillin/tazobactam and nitrofurantoin could be used as the first-choice drugs.

关 键 词：医院感染 枸橼酸杆菌 耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]