不同临床标本分离CRE流行病学与耐药性研究  

Epidemiological and antibiotic resistance studies of CRE isolated from different clinical specimens

作　　者：李华锋 黎彩珍 雷桂炎 梁永祥 LI Hua-feng;LI Cai-zhen;LEI Gui-yan(Department of Clinical Laboratory,Xinxing County People's Hospital,Xinxing 527400,China)

机构地区：[1]新兴县人民医院检验科,527400 [2]新兴县人民医院呼吸内科,527400

出　　处：《中国现代药物应用》2024年第12期80-83,共4页Chinese Journal of Modern Drug Application

基　　金：广东省云浮市科技局科研项目(项目编号:WS2022031008)。

摘　　要：目的明确本地区医疗机构耐碳青霉烯类肠杆菌科细菌(CRE)流行病学特征和耐药性情况,为当地医疗机构防治CRE感染提供科学依据。方法应用Vitek2 Compact等设备对日常微生物检验的临床标本进行致病菌鉴定和药敏试验,遴选出CRE菌株,再进一步进行耐药性分析,最后统计资料分析CRE的流行病学特征和耐药性情况。结果共收到微生物检验标本19298份,除去重复统计,共分离出91株CRE;其中大肠埃希氏菌24株、占26.4%,肺炎克雷伯氏菌46株、占50.5%,阴沟肠杆菌14株、占15.4%,其他7株、占7.7%;91株CRE中,产A类丝氨酸酶有38株、占41.8%,产B类金属酶有52株、占57.1%,产混合型丝氨酸酶和金属酶有1株、占1.1%;分离出CRE的痰标本占比最大、占49.5%(45/91),分离出CRE的呼吸内科标本占比最高、占26.4%(24/91);丁胺卡那和替加环素对CRE的敏感性最高,均为53.8%(49/91)。结论呼吸内科是CRE感染的主要科室,痰标本分离出CRE的几率最高,产B类金属酶是该医疗机构CRE主要的耐药机制,肺炎克雷伯氏菌是主要的CRE,丁胺卡那和替加环素仍然可用于抗CRE感染治疗。Objective To understand the epidemiology and drug resistance of carbapenem-resistant enterobacteriaceae(CRE)in local medical institutions,and to provide scientific basis for the prevention and treatment of CRE infection in local medical institutions.Methods VITEK2 Compact was used to identify pathogenic bacteria and drug sensitivity test of clinical specimens from routine microbiological examination,and the strains of CRE were selected and further drug resistance analysis was carried out,finally,the epidemiological characteristics and drug resistance of CRE were analyzed.Results A total of 19298 microbiological specimens were collected,and 91 strains of CRE were isolated after removing duplicate,including 24 strains(26.4%)of Escherichia coli and 46 strains(50.5%)of Klebsiella pneumoniae,14 strains(15.4%)of Enterobacter cloacae,and 7 other strains(7.7%).Among 91 CRE strains,38 strains(41.8%)produced serine A,52 strains(57.1%)produced metalloenzyme B,and 1 strain(1.1%)produced mixed serine and metalloenzyme.Sputum specimens had the highest probability of CRE isolation,accounting for 49.5%(45/91),and the specimens from the respiratory department had the highest probability of CRE isolation,accounting for 26.4%(24/91);the sensitivities to CRE for amikacin and tigecycline were the highest,accounting for 53.8%(49/91).Conclusion Respiratory department is the main department of CRE infection,and the rate of CRE isolation from sputum is the highest.The main resistance mechanism of CRE in this hospital is the production of metalloenzyme B,and Klebsiella pneumoniae is the main CRE,amikacin and tigecycline are still available for the treatment of CRE infection.

关 键 词：耐碳青霉烯类肠杆菌科细菌 感染:碳青霉烯酶 耐药 流行病学 

分 类 号：R446.5[医药卫生—诊断学]