2019~2022年柠檬酸杆菌属耐药与临床分离情况分析

Analysis of drug resistance and clinical isolation of citrobacillus from 2019 to 2022

目的分析潍坊市人民医院柠檬酸杆菌属细菌的药敏结果及临床分离情况,为规范临床科室用药和降低细菌感染率提供科学依据。方法收集2019年1月~2022年12月潍坊市人民医院临床标本中分离的柠檬酸杆菌,筛选菌株均经BD Phoenix M50全自动微生物药敏系统进行药敏测试和质谱仪进行鉴定,分析菌株的耐药特点及临床分离情况。结果从临床标本中共分离225株柠檬酸杆菌(2019~2022年分别为5株、61株、77株、82株),主要来源为老年患者;尿液标本占比最高;药敏结果显示菌株对头孢他啶、氨曲南等抗菌药物耐药率较高,均在30%以上;不同柠檬酸杆菌属对美罗培南、头孢曲松、阿米沙星、氨曲南、环丙沙星、头孢噻肟、左氧氟沙星、头孢他啶等抗菌药物的耐药率差异有统计学意义(P<0.05);与普通菌株相比,碳青霉烯类耐药组多重耐药率高于普通菌株,差异有统计学意义(P<0.05)。结论2019~2022年潍坊市人民医院临床分离的柠檬酸杆菌呈递增趋势,柠檬酸杆菌对碳青霉烯类药物维持在较高的敏感率,但研究也发现碳青霉烯类耐药的肠杆菌科细菌(CRE)已经出现,且碳青霉烯类耐药组多重耐药率高于普通菌株,应加强耐药监测,指导临床规范用药,控制耐药株的流行。

Objectivee To analyze the results of drug sensitivity and clinical distribution of citrobacter in Weifang People's Hospital to provide scientific basis for regulating drug use in clinical departments and reducing infection rate.Methods Citrobacter isolated from clinical specimens in Weifang People's Hospital from January 2019 to December 2022 was collected.The selected strains were tested by BD Phoenix M50 automatic microbial drug sensitivity system and identified by mass spectrometer,and the drug resistance characteristics and clinical distribution of the strains were analyzed.Results A total of 225 strains were isolated from clinical specimens(5,61,77 and 82 strains,respectively,during 2019~2022),mainly from elderly patients.Urine samples accounted for the highest proportion;The drug sensi30%. The resistance of different Citrobacter genera to meropenem, ceftriaxone, amifloxacin ,amtronam ,ciprofloxacin, cefotaxime, levofloxacin, ceftazidme and other antibiotics was statistically significant( P<0. 05). The multiple drug resistancerate of carbapenem resistance group was higher than that of common strains , and the difference was statistically significant(P<0. 05). Conclusion The clinical isolated citrobacter from Weifang People's Hospital from 2019 to 2022 showed anincreasing trend, and Citrobacter maintained a high sensitivity to carbapenem drugs. However, the study also found thatcarbapenem resistant Enterobacteriaceae bacteria(CRE) had emerged,and the multiple drug resistance rate of carbapenemresistant group was higher than that of common strains, which brought great challenges to clinical treatment. Drug resistancemonitoring should be strengthen to guide clinical standardized drug use, and control the prevalence of drug-resistantstrains.