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| 某三级医院耐碳青霉烯肠杆菌目细菌的分布和耐药性分析 |
| Distribution and drug resistance analysis of carbapenem-resistant Enterobacterales in a hospital |
| 投稿时间：2022-04-09 修订日期：2022-06-04 |
| DOI： |
| 中文关键词: 碳青霉烯酶;肠杆菌目;分布;耐药 |
| 英文关键词: Carbapenemase; Enterobacterales; Distribution; Drug resistance |
| 基金项目:青大附院“临床医学+X”科研项目(2019-3399)； |
| 作者 | 单位 | 邮编 | | 李霞 | 临沂市中心医院检验科 | 276400 | | 刘入华 | 青岛大学附属医院 | | | 刘艳飞 | 青岛大学附属医院 | | | 刘健 | 临沂市中心医院检验科 | | | 朱元祺* | 青岛大学附属医院 | 266003 |
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| 中文摘要: |
| 目的 了解某三级医院分离的耐碳青霉烯类肠杆菌目细菌（CRE）的分布和耐药表型，为合理用药提供依据。方法 通过布鲁克质谱仪和Vitek Compact对2019年1月～2021年11月期间分离的所有肠杆菌目细菌进行鉴定和药敏试验。临床资料分析采用回顾性方法。结果 从2019年1月到2021年11月，共分离出169株CRE,检出率为1.64%（169/10274）。在这些CRE菌株中,大肠埃希菌（CR-ECO）、肺炎克雷伯菌（CR-KPN）和阴沟肠杆菌分别占62.72%（106/169）、20.71%（35/169）和10.65%（18/169），主要分离自尿液（68株）、痰液（35株）和血液（24株）。CRE分离的主要科室是ICU（32株）、泌尿外科（24株）和肾内科（19株）。药敏结果显示，除了对替加环素都敏感外，这169株CRE对头孢类、碳青酶烯类、喹诺酮类和氨基糖苷类抗菌药物呈现不同程度的耐药。 结论 该医院CRE检出率低于全国平均水平，但呈现多重耐药。因此，有必要加强对耐碳青霉烯类肠杆菌目细菌的监测，以预防CRE菌株的流行传播和暴发。 |
| 英文摘要: |
| Objective To investigate the distribution and drug resistance phenotype of carbapenem-resistant Enterobacterales (CRE) isolated from a hospital, and to provide evidence for rational drug use. Methods All Enterobacteriaceae bacteria isolated between January 2019 and November 2021 were identified using Bruker mass spectrometer and antimicrobial susceptibility testing（AST）were performed using Vitek2 Compact system. Clinical data were analyzed retrospectively.Results From January 2019 to November 2021, 169 CRE strains were isolated from clinical specimens in the hospital, and the detection rate of the CRE was 1.64%（169/10274）. Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae is accounted for 62.72% (106/169), 20.71% (35/169) and 10.65% (18/169) of these CRE strains, respectively. These CRE strains were mainly isolated from urines (68 strains), sputums (35 strains) and blood (24 strains). And these CRE isolates were mainly recovered from the departments of ICU (32 strains), urology (24 strains) and nephrology (19 strains). The results of AST demonstrated that the 169 CRE strains showed different degrees of drug resistance to cephalosporins, carbapenems, quinolones and aminoglycosides except for tigecycline.Conclusion The detection rate of CRE in this hospital was lower than that of the national surveillance average, but these CRE strains showed multiple drug resistance phenotype. Therefore, it is necessary to strengthen the surveillance of carbapenem-resistant Enterobacterale so as to prevent the epidemic spread and outbreak of the CRE strains. |
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