碳青霉烯耐药肠杆菌目细菌1528株流行病学特征与耐药性分析
Epidemiological Characteristics and Drug Resistance of 1528 Strains of Carbapenem-resistant Enterobacterales
闫琳琳 1杨瑞锋1
作者信息
- 1. 北京大学首钢医院检验科,北京 100144
- 折叠
摘要
目的 了解北京西部地区碳青霉烯耐药肠杆菌目细菌(Carbapenem-resistant Enterobacteriales,CRE)的流行病学特征及其对常见抗菌药物的敏感性.方法 回顾性分析2014年1月至2023年12月北京大学首钢医院临床分离的1528株CRE的结果,分析CRE菌株构成、检出率、分布特征及抗菌药物敏感性.结果 10年间,共分离9 774株肠杆菌目细菌,其中CRE阳性1528株,检出率为15.63％(1528/9774),以肺炎克雷伯菌(77.36％,1182/1528)、大肠埃希菌(7.26％,111/1528)和产气肠杆菌(4.78％,73/1528)最为常见.CRE检出率从2014年的8.84％上升至2023年的23.56％,呈上升趋势(P＜0.0001).呼吸重症监护室、重症监护室和干部保健/监护病区是CRE感染高发病区,检出率分别为48.77％(178/365)、38.64％(427/1105)和34.88％(150/430).CRE感染多发生于60岁以上老年患者,以呼吸道感染和泌尿道感染为主,占比分别为64.14％(980/1528)和 18.65％(285/1528).CRE 对阿米卡星(53.49％)、复方新诺明(52.67％)和氯霉素(49.93％)的敏感率较高,对碳青霉烯类的敏感率较低(＜8.95％).此外,碳青霉烯耐药肺炎克雷伯菌(Carbapenem-resistant Klebsiella pneumoniae,CR-KPN)对亚胺培南和美罗培南的最低抑菌浓度(minimum inhibitory concentration,MIC)较高(≥8mg/L的比例分别为93.71％和95.88％).结论 CRE在本院患者检出率较高,尤其监护病区和老年患者.CRE多呈广泛耐药且对碳青霉烯类抗生素的M1C较高.
Abstract
Objective lo analyze and evaluate epidemiological characteristics of Carbapenem-resistant Enterobacteriales(CRE)and their susceptibilities to antibacterial drugs in the western area of Beijing.Methods This was a retrospective study conducted at Peking University Shougang Hospital from January,2014 to December,2023.Enterobacteriales isolates from clinical specimens and the clinical and laboratory data were collected.The composition,detection rate,distribution characteristics and antimicrobial susceptibility of CRE were analyzed and evaluated.Results In the past 10 years,a total of 9774 strains of Enterobacteriales were isolated,and 1528 isolates were CRE positive,resulting in a detection rate of 15.63％(1528/9774).Among 1528 CRE isolates,Klebsiella pneumoniae accounted for the highest proportion(77.36％,1 182/1528),followed by Escherichia coli(7.26％,111/1528)and Enterobacter aerogenes(4.78％,73/1 528).The detection rate of CRE increased from 8.84％in 2014 to 23.56％in 2023,with a significant upward trend(P＜0.0001).CRE strains were more frequently isolated in Respiratory Intensive Care unit,Intensive Care unit,and Cadre Health/care wards,with a detection rate of 48.77％(178/365),38.64％(427/1 105)and 34.88％(150/430),respectively.CRE infection was more common in elderly patients over 60 years old,and was mainly obtained from respiratory tract infection(64.14％,980/1 528)and urinary tract infection(18.65％,285/1528).Anti-microbial susceptibility testing of the 1 528 CRE isolates showed that amikacin had the highest susceptibility(53.49％),followed by trimethoprim-sulfamethoxazole(52.67％)and chloramphenicol(49.93％),while they showed low susceptibilities to Carbapenem(＜8.95％).Moreover,93.71％and 95.88％of Carbapenem-resistant K.pneumoniae(CR-KPN)had an MIC≥8mg/L for imipenem and meropenem,respectively.Conclusion The detection rate of CRE is high in our hospital,especially in the care unit and elderly patients.CRE is mostly extensive drug resistant and has higher MIC values for Carbapenem.
关键词
碳青霉烯耐药肠杆菌目/检出率/抗菌药物敏感性试验Key words
Carbapenem-resistant Enterobacterales/Detection rate/Antimicrobial susceptibility testing引用本文复制引用
基金项目
石景山区医学重点扶持专科建设项目(石卫健医发[2020]21号)
出版年
2024
NETL
NSTL
万方数据