医院耐碳青霉烯类肠杆菌科细菌临床特征和耐药分析

Analysis for the clinical characteristics of the bacteria resistant to carbapenems enterobacteriaceae

目的研究石家庄市人民医院156株耐碳青霉烯类肠杆菌科细菌(CRE)的临床特征和耐药情况,为防控院内感染和优化临床用药提供强有力的依据。方法收集2019年1月1日至2020年5月1日分离的156株CRE,回顾性调查,同源性分析,采用WHONET 5.5软件进行统计分析。结果收集156株CRE中,以肺炎克雷伯菌(80.1%)为主,标本来源以痰液(41.7%)为主。科室分布以重症监护病房ICU(48.7%)为主,改良碳青霉烯酶灭活试验(mCIM试验)阳性率为82.1%,以肺炎克雷伯菌为主(86%),EDTA改良碳青霉烯酶灭活试验(eCIM试验)分析其产酶类型,其中肺炎克雷伯菌主要以产丝氨酸酶为主(86.4%),大肠埃希菌以产金属碳青霉烯酶为主(77.8%)。结论CRE临床感染现状较为严峻,应加强监测,防止并控制传播;mCIM试验与eCIM试验检测快速简便,有较高的应用价值。

Objective To investigate the clinical characteristics and drug resistance of 156 strains of Carbapenems enterobacteriaceae(CRE)in our hospital,so as to provide basis for preventing and controlling nosocomial infection and optimizing clinical medication.Methods A total of 156 strains of carbapenem-resistant enterobacteriaceae(CRE)were collected in our hospital from January 1,2019 to May 1,2020,then the clinical characteristics and drug resistance of CRE were retrospective analyzed,moreover,the homology was statistically analyzed by using WHONE 5.5 software.Results Of the 156 strains of CRE,there were mainly Klebsiella pneumoniae(80.1%),and sputum(41.7%),and sputamentum was the main source of specimens.The distribution department was mainly in ICU,in which,the modified carbon penicillium inactivated enzyme test(mCIM test)positive rate was 82.1%,mainly klebsiella pneumoniae(86%),and EDTA modified carbon penicillium inactivated enzyme test(eCIM test)was used to analyze the type of enzyme production,there were mainly pneumonia klebsiella bacteria mainly produce serine enzyme(86.4%),and E.coli mainly produced metal carbon green alkene enzyme(77.8%).Conclusion The present situation of CRE clinical infection is serious,therefor,it is necessary to strengthen surveillance to prevent and control its spreading.MCIM test and eCIM test are fast and simple,both have higher application value.