Distribution of carbapenem-resistant Enterobacteriaceae bacteria and its drug resistance isolated from elderly patients
OBJECTIVE To analysis the changes of pathogenic distribution and drug resistance of carbapenem-resist-ance Enterobacteriaceae(CRE)bacteria isolated from elderly patients in our hospital,and to provide reference ba-sis for clinical prevention and treatment of CRE infection in the elderly.METHODS Enterobacteriaceae bacteria iso-lated from specimens of elderly patients between 60 years old and 106 years old in the Second Medical Center of Chinese PLA General Hospital between Jan 1,2017 to Oct 31,2022.Strains were identified by VITEK-2 compact automatic microbial identification instrument and automatic biomass spectrum detector microfilex.Drug suscepti-bility test of Enterobacteriaceae bacteria was carried out in vitro by drug sensitive card and disk diffusion method.The detection rates,variation trends,specimen source,strain composition,departments'distribution and drug re-sistance of CRE were analyzed.RESULTS A total of 677(32.27％)CRE strains were isolated from Jan 1.2017 to Oct31,2022,and the detection rates of CRE showed an overall increasing trend.Carbapenem-resistant Klebsiella pneumoniae(CRKP)was the main strain of CRE in our hospital(75.48％),followed by carbapenem-resistant Escherichia coli(CREC)(11.37％)and carbapenem-resistant Enterobacter aero genes(CREA)(7.98％).The de-tection rate of CRKP was the highest but there was no obvious linear trend.However,the detection rates of CREC and CREA were obvious increased year by year and the trend is obvious.CRE strains were mainly isolated from re-spiratory tract specimens(61.30％),and the respiratory care unit had the highest detection rate(45.87％).Drug sensitivity test in vitro showed most of CRE stains were multi-drug resistant.The drug resistance rates of the main CRE to penicillins,cephalosporins and β-lactam/β-lactamase inhibitor complexes were over 75％,while they had relatively good drug susceptibility to tigecycline,amikacin,tetracycline and trimethoprim/sulfamethoxazole.The drug resistance spectrum of the three strains of CRE were different.CONCLUSION The detection rate of CRE eld-erly patients in our hospital is generally high,which are distributed in many departments and drug-resistant to most commonly used clinical antibiotics.Early identification and active screening of elderly CRE patients should be strengthened,and clinical department should rationally use of antibiotics.Measures including contact prevention,isolation and environmental cleaning should be carried out to reduce the infection of CRE in geriatric wards.
CarbapenemaseEnterobacteriaceaeDrug resistanceVariation of infectionElderly patients
NETL
NSTL
万方数据
