医院感染耐碳青霉烯类肠杆菌科分布及耐药性分析

Clinical distribution and drug resistance of carbapenem resistant Enterobacteriaceae in hospital

目的了解临床分离耐碳青霉烯类肠杆菌科分布及其耐药情况,为指导临床合理使用抗菌药物提供参考。方法通过细菌分离鉴定技术,对某医院住院患者送检病原学标本进行检测与分析。结果从该医院住院患者送检标本中共分离耐碳青霉烯类肠杆菌科(CRE)细菌322株,包括肺炎克雷伯菌198株(含臭鼻克雷伯菌1株)、粘质沙雷菌78株和大肠埃希菌46株。CRE菌株主要分离自重症监护室、神经外科和呼吸内科病房送检的标本;居首位的标本是痰液,占68.42%。临床分离的CRE菌株对常用抗菌药物高度耐药。结论医院感染CRE细菌主要是肺炎克雷伯菌、粘质沙雷菌和大肠埃希菌,耐药严重,多见于呼吸道感染,应当依据药敏结果选用抗菌药物。

Objective To understand the distribution and drug resistance of carbapenem resistant enterobacteriaceae（ CRE）,and to provide guidance for clinical rational use of antimicrobial agents. Methods Bacterial isolation and identification technology were used to test and analyze the pathogenic specimens of hospitalized patients in a hospital.Results 322 strains of CRE bacteria,including 198 strains of Klebsiella pneumoniae（ including 1 strains of ozena Klebsiella pneumoniae）,78 strains of Serratia mucilinae,and 46 strains of Escherichia coli were isolated from the hospitalized patients.CRE was mainly isolated from intensive care unit,department of neurosurgery and respiratory medicine ward. The first specimen was sputum,accounting for 68. 42%. Clinically isolated CRE strains were highly resistant to commonly used antimicrobials. Conclusion The main CRE bacteria in hospital infection are Klebsiella pneumoniae,salebella mucilosiae and Escherichia coli. The drug resistance is serious and often occurs in the respiratory tract infection. Antimicrobial agents should be selected according to the drug sensitivity results.