耐碳青霉烯类革兰阴性菌分布特征及耐药性分析

Distribution characteristics and drug resistance analysis of carbapenem resistant organisms

目的了解临床分离耐碳青霉烯类革兰阴性菌分布特征及耐药性,为指导临床合理使用抗菌药物提供依据。方法通过回顾性的方法,对某医院临床分离的耐碳青霉烯类革兰阴性菌(CRO)分布特征及其耐药性进行调查与分析。结果某医院在2018—2020年期间从临床送检标本中共诊断出CRO菌株感染患者1290例,其中耐碳青霉烯类肠杆菌(CRE)436例,占33.80%;碳青霉烯耐药鲍曼不动杆菌(CRAB)499例,占38.68%;碳青霉烯耐药铜绿假单胞菌(CRPA)355例,占27.52%。临床分离CRO主要来自重症医学科、神经外科和呼吸危重症科,主要分离自痰液、尿液和分泌物。CRO对临床常用抗菌药物广泛耐药且耐药性较高。结论该医院耐碳青霉烯类革兰阴性菌分离率较高,应加强耐药菌监测和感染链控制。

Objective To understand the distribution characteristics and drug resistance of carbapenem resistant organisms(CRO)isolated from clinical practice,and to provide the basis for guiding the rational use of antibiotics in clinic practice.Methods The distribution characteristics and drug resistance of CRO isolated from a hospital were investigated and analyzed retrospectively.Results A total of 1290 patients with CRO infection were diagnosed by analyzing the clinical specimens in a hospital from 2018 to 2020,including 436 cases of carbapenem-resistant Enterobacteriaceae(CRE)accounting for 33.80%,499 cases of carbapenem-resistant Acinetobacter baumannii(CRAB)accounting for 38.68%,and 355 cases of carbapenem-resistant Pseudomonas aeruginosa(CRPA)accounting for 27.52%.The clinically isolated CROs were mainly from the department of critical care medicine,neurosurgery and respiratory critical care,They were mainly isolated from sputum,urine and secretions.CROs were widely resistant to commonly used clinical antibiotics and had high drug resistance.Conclusion The isolation rate of carbapenem-resistant organisms is high in this hospital,and the monitoring of drug-resistant bacteria and infection chain control should be strengthened.