儿童患者耐碳青霉烯肠杆菌的分布及药物敏感性分析

Distribution and drug sensitivity of carbapenem-resistant Enterobacteriaceae isolated from children

目的了解我院儿童患者2013—2017年临床分离的耐碳青霉烯肠杆菌(CRE)的分布及耐药情况,为控制和治疗此类菌引起的感染提供用药依据。方法采用VITEK 2 Compact全自动微生物鉴定药敏仪对该类细菌进行药敏实验,参考CLSI-M100折点标准,WHONET5.6软件进行结果分析,采用χ2检验进行统计分析。结果 2013—2017年,临床共分离出687株CRE菌株,总检出率10.64%。主要为肺炎克雷伯菌(302株)、大肠埃希菌(213株)、奇异变形杆菌(72株)。5年的CRE检出率基本呈上升趋势,标本主要来源于尿液(38.14%),其次为呼吸道(30.13%)。CRE菌株对氨基糖苷类和喹诺酮类抗菌药物耐药率<30%,但对其他β-内酰胺类药物耐药率则基本在70%以上。结论CRE菌株在儿童患者感染中呈逐年上升趋势,并大多表现为多药耐药菌株。

Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae （CRE） of 2013-2017-year clinically isolated from children in our hospital, and to provide a basis for control and treatment of infections caused by such bacteria. Methods The VITEK 2 Compact automatic microbiological identification drug sensitive instrument was used to carry on the drug sensitivity test to this kind of bacterium, and refer to the CLSI-M100 standard to carry on the drug sensitivity experiment. WHONET5.6 software was used for the result analysis, and ？（2 test was used to carry out statistical analysis. Results From 2013 to 2017, 687 strains of CRE were isolated clinically, and the detection rate was 10.64%. The strains were Klebsiella pneumoniae （302 strains）, Escherichia coli （213 strains） and Proteus （72 strains）. The detection rate of CRE showed an upward trend in 5 years. The specimens were mainly from urine （38.14%） and respiratory tract （30.13%）. The resistant rates of CRE strains to aminoglycoside and quinolone antimicrobial agents were 〈 30%, but which of other beta-caprolactam drugs were more than 70%. Conclusion The strain of CRE shows increasing trend in children＇ s infection, and most of them are multi-drug resistant strains.