耐碳青霉烯类肠杆菌科细菌的分布特点及其耐药性分析

Distribution and Drug Resistance Analysis of carbapenem-resistant Enterobacteriaceae

目的对耐碳青霉烯类肠杆菌科细菌(CRE)的分布特点进行分析,并探究其耐药性。方法对周口市中心医院2016年8月至2018年10月临床标本分离出来的152株CRE进行收集,均行菌株测定与细菌分析,分析细菌分布特点与耐药情况。结果研究共收集菌株152株,菌株类型共5种,肺炎克雷伯菌所占比例最高,为47.37%,其次为大肠埃希菌,占43.42%。呼吸道为主要标本来源,占61.84%,其次为尿液,占21.05%。除了多黏菌素、替加环素、阿米卡星这3种药物之外,CRE对其他各种药物的耐药性均在70%以上;CRE对头孢唑啉、头孢噻肟、头孢他啶、厄他培南、阿莫西林/克拉维酸、头孢曲松、亚胺培南、四环素、环丙沙星具有较高耐药性,均在90%以上。大肠埃希菌与肺炎克雷伯菌对头孢噻肟、头孢他啶、头孢唑啉均具有较高耐药性。结论CRE标本来源较为广泛,大肠埃希菌与肺炎克雷伯菌为最常见菌株类型,且具有高耐药性特点,临床应合理应用抗菌药物,并对其加强管理。

Objective To analyze the distribution characteristics of carbapenem-resistant Enterobacteriaceae(CRE)and explore its drug resistance.Methods From August 2016 to October 2018,152 strains of CRE isolated from clinical specimens were collected from Zhoukou Central Hospital,all strains were detected and bacteria analysis,and bacterial distribution characteristics and drug resistance were analyzed.Results A total of 152 strains were collected.There were 5 types of strains.Klebsiella pneumoniae accounted for 47.37%,Escherichia coli for 43.42%.Respiratory tract was the main source of specimens(61.84%),followed by urine(21.05%).In addition to Polymyxin,Tigecycline,Amikacin,CRE to other drugs of drug resistance are above 70%;CRE was resistant to Cefazolin,Cefotaxime,Ceftazidime,Ertapenem,Amoxicillin/Clavulanic Acid,Ceftriaxone,Imipenem,Tetracycline and Ciprofloxacin,all above 90%.Escherichia coli and Klebsiella pneumoniae were highly resistant to Cefotaxime,Ceftazidime and Cefazolin.Conclusion CRE is of extensive origin,Escherichia coli and Klebsiella pneumoniae are the most common strains,and have high drug resistance,so antibiotics should be used reasonably and management should be strengthened.