首页|不同临床标本分离CRE流行病学与耐药性研究

不同临床标本分离CRE流行病学与耐药性研究

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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.
Epidemiological and antibiotic resistance studies of CRE isolated from different clinical specimens
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 19 298 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.

Carbapenem-resistant enterobacteriaceaeInfectionCarbapenemasesResistanceEpidemiology

李华锋、黎彩珍、雷桂炎、梁永祥

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527400 新兴县人民医院检验科

527400 新兴县人民医院呼吸内科

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

2024

中国现代药物应用
中国水利电力医学科学技术学会

中国现代药物应用

影响因子:0.862
ISSN:1673-9523
年,卷(期):2024.18(12)