摘要
目的 分析某院临床分离肠杆菌科细菌分布特征及其耐药性.方法 82株肠杆菌科细菌分离自2021年1月-2022年12月于我院治疗患者的血、尿、痰、大便及分泌物等标本.采用全自动微生物鉴定仪进行病原菌种类鉴定,采用纸片扩散法及琼脂平板稀释法进行药敏鉴定.结果 82株病原菌中大肠埃希菌有33株,占比40.24％;肺炎克雷伯菌29株,占比35.37％,肠杆菌10株,占比12.20％,变形杆菌10株,占比变形杆菌12.20％;82株病原菌中痰液标本来源有50株,占比60.98％(50/82);血标本来源17株,占比20.73％(17/82);尿液标本来源11株,占比13.41％(11/82),分泌物及大便标本来源各有3株、1株;大肠埃希菌ESBLs检出31株(93.94％),CRE检出2株(6.06％);肺炎克雷伯菌MDR检出26株(89.66％),CRE检出3株(10.34％);肠杆菌MDR检出7株(70.00％),CRE检出3株(30.00％);变形杆菌MDR检出10株(100.00％);大肠埃希菌对厄他培南、亚胺培南、美罗培南、阿米卡星、头孢哌酮/舒巴坦耐药率较低(耐药率均≤10％);肺炎克雷伯菌对厄他培南、亚胺培南、美罗培南、阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦耐药率较低(耐药率均≤10％);肠杆菌、变形杆菌均对厄他培南、亚胺培南、美罗培南、阿米卡星耐药率较低(耐药率均≤10％);肠杆菌科细菌对氨苄西林/舒巴坦、头孢曲松、头孢呋辛、头孢唑林、氨苄西林耐药率均较高(耐药率＞50％).结论 某院临床分离肠杆菌科细菌以大肠埃希菌、肺炎克雷伯菌最为常见,痰液、血液为肠杆菌科细菌标本主要来源,肠杆菌科细菌的ESBLs、MDR检出率较高,需要依据药敏结果合理使用抗菌药物.
Abstract
Objective To analyze the distribution characteristics and drug resistance of Enterobac-teriaceae bacteria isolated in a hospital.Methods A total of 82 strains of Enterobacteriaceae were isolated from blood,urine,sputum,stool and secretions from patients treated in our hospital from January 2021 to December 2022.The automatic microbial identification instrument was used for the identification of pathogenic bacteria,and the diffusion method of paper discs and agar plate dilution method were used for drug susceptibility identification.Results Among the 82 pathogenic strains,33 strains of Escherichia coli were strained,accounting for 40.24％.There were 29 strains of Klebsiella pneumoniae,accounting for 35.37％,10 strains of Enterobacteriace-ae,accounting for 12.20％,and 10 strains of Proteus,accounting for 12.20％of Proteus.A-mong the 82 strains of pathogenic bacteria,50 sputum samples were sourced,accounting for 60.98％(50/82).17 blood samples were sourced,accounting for 20.73％(17/82);There were 11 strains of urine specimens,accounting for 13.41％(11/82),and 3 strains and 1 strain of se-cretions and stool specimens,respectively.31 strains(93.94％)and 2 strains(6.06％)were de-tected in CRE of Escherichia coli ESBLs.Twenty-six strains(89.66％)were detected in MDR and 3(10.34％)strains were detected in CRE.7 strains(70.00％)were detected by MDR and 3(30.00％)strains were detected by CRE.10 strains(100.00％)were detected by Proteus MDR;Escherichia coli had a low resistance rate to ertapenem,imipenem,meropenem,amikacin,and cefoperazone/sulbactam(all＜10％).The resistance rate of Klebsiella pneumoniae to ertapen-em,imipenem,meropenem,amikacin,piperacillin/tazobactam,and cefoperazone/sulbactam was low(all ≤10％);Enterobacter and Proteus had low resistance rates to ertapenem,imipen-em,meropenem and amikacin(all＜10％).Enterobacteriaceae had a high resistance rate to am-picillin/sulbactam,ceftriaxone,cefuroxime,cefazolin,and ampicillin(resistance rate＞50％).Conclusion Escherichia coli and Klebsiella pneumoniae are the most common clinical isolates of Enterobacteriaceae bacteria in a hospital,and sputum and blood are the main sources of Enter-obacteriaceae bacterial specimens,and the detection rates of ESBLs and MDR of Enterobacteri-aceae bacteria are high,so it is necessary to use antimicrobial drugs rationally according to the drug sensitivity results.
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