碳青霉烯类耐药肠杆菌科细菌的临床分布与耐药性分析

CLINICAL DISTRIBUTION CHARACTERISTICS AND DRUG RESISTANCE ANALYSIS OF CARBOPENEM RESISTANT ENTEROBACTERIACEAE

目的:分析探讨碳青霉烯类耐药的肠杆菌科细菌(CRE)临床分布与其耐药率。方法:收集我院各个临床科室检验标本中,所分离出的耐碳青霉烯类抗菌药物的肠杆菌科细菌(CRE),使用VITEK 2 Compact全自动微生物鉴定药敏分析系统,对收这些菌株进行了鉴定和药敏分析,用纸片扩散法(K-B)对亚胺培南耐药结果进行复核,用改良Hodge试验对产酶情况进行确认,将结果进行回顾性统计分析。结果:50.0%的CRE菌株来自于呼吸道感染痰液标本,24.35%来自于泌尿系感染的尿液标本;58.69%的标本来自在各科室的重症病房,其次是老干部保健病房和肿瘤病房,分别占13.48%和12.61%。药敏结果显示CER除了对阿米卡星的耐药率较低(83.12%),对其他类抗菌药物则表现为高耐药率,均在86.02%以上。结论:耐碳青霉烯类药物的肠杆菌科细菌(CRE)突出表现为高耐药性,临床的分布也有非常明显的特征,重症监护病房比例最大。

Objective:to analyze the clinical distribution characteristics and drug resistance rate of carbopenem resistant enterobacteriaceae(CRE).Methods:The strains of carbopenem resistant enterobacteriaceae were Collected from various clinical departments.The identification and drug sensitivity test of those strains were tested by VITEK 2 Compact microbial analysis system.Kirby-Bauer(k-b)was used to review the results of imipenem resistance,and improved Hodge test was used to confirm the enzyme production of CRE,and the results were statistically analyzed.Results:50.0%of the CRE strains were from sputum specimens of respiratory tract infection,and24.35%were from urine specimens of urinary tract infection.58.69%of the samples were distributed in intensive care units,followed by cadre care units and oncology units,accounting for13.48%and12.61%,respectively.The drug sensitivity results showed that the drug resistance rate of CER to amikacin was relatively low(83.12%),while that to other antibiotics was very high(above86.02%).Conclusion:carbopenem resistant enterobacteriaceae(CRE)show high drug resistance and are distributed in intensive care units.