2018年1月至2019年6月江门市某医院耐碳青霉烯类肠杆菌科细菌耐药性分析

Drug resistance Analysis of Carbapenem-resistant Enterobacteriaceae in a Hospital in Jiangmen from January 2018 to June 2019

目的研究耐碳青霉烯类肠杆菌科细菌耐药性,为临床用药提供指导。方法此次研究于2018年1月至2019年6月选取江门市某家三甲医院8938例患者的临床标本进行研究,通过自动化检测仪器及纸片扩散法,对耐碳青霉烯类肠杆菌科细菌菌株进行药物敏感性试验,统计分析细菌的分布情况及耐药性。结果共检出的耐碳青霉烯类肠杆菌科细菌共计141株,在病原菌分布特点方面:其中占比最高的病原菌是肺炎克雷伯菌,所占比例为23.40%,其次是大肠埃希菌和摩根摩根菌,均为17.02%;第三是阴沟肠杆菌,为16.31%;研究中获得的耐碳青霉烯类肠杆菌科细菌标本,主要分离于呼吸道,占比是39.01%,其次是各类伤口分泌物、中段尿;研究结果表明,耐碳青霉烯类肠杆菌科细菌对于大部分抗菌药物,均具有较高的耐药率,仅对替加环素的耐药性较差,为5.12%,总体来说对于碳青霉烯类药物的耐药性是26.80%-77.30%。耐碳青霉烯类肠杆菌科细菌不同病原菌的耐药性存在一定差异,肺炎克雷伯菌的耐药性相对较高。结论耐碳青霉烯类肠杆菌科细菌对于大部分的常用抗菌药物,会呈现耐药性,增加了临床抗感染治疗的难度,临床治疗中,需要加大对此类抗菌药物耐药性进行监测的力度,同时针对耐药性较大细菌的传播采取针对性的防控措施。

Objective to study resistance of carbapenem-resistant enterobacteriaceae bacteria and provide guidance for clinical medication.Methods choose 8,38 patients from grade-A tertiary hospital in Jiangmen city from January 2018 to June 2019 as clinical study samples.Detect carbapenem-resistant enterobacteriaceae with automated testing equipment and paper diffusion method,and carry on statistics and analysis of distribution and resistance of bacteria.Results 141 strains of carbapenem-resistant enterobacteriaceae were detected.In terms of pathogenic bacteria distribution characteristics,Klebsiella pneumoniae had the highest proportion of pathogenic bacteria,accounting for 23.40%,followed by escherichia coli and morganella,both for 17.02%;the third is enterobacter cloacae,with 16.31%;carbapenem-resistant enterobacteriaceae bacterial samples were obtained in study mainly from respiratory tract,accounting for 39.01%,secondly from all kinds of wound secretions and mid-stage urine.Results show that carbapenem-resistant enterobacteriaceae bacteria have high drug resistance rate for most antibacterial drugs,only with less resistance to tigecycline,5.12%,overall resistance to carbapenems is 26.80%-77.30%.Carbapenem-resistant enterobacteriaceae bacteria have different resistance to different pathogens,and Klebsiella pneumoniae has relatively high resistance.Conclusion carbapenem-resistant enterobacteriaceae bacteria are resistant to most commonly used antibacterial drugs,which increases difficulty of clinical anti-infective treatment.In clinical treatment,it is necessary to increase monitoring of drug resistance of antibiotics,and take targeted prevention and control measures against spread of bacteria with high drug resistance.