某院产超广谱β-内酰胺酶肠杆菌科细菌的临床分布与耐药性分析

Clinical Distribution and Drug Resistance Analysis of Extended-Spectrumβ-Lactamase Enterobacteriaceae Bacteria in a Hospital

目的:探讨产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌的临床分布与耐药性情况,为防控医院感染提供参考。方法:选取2021年7月—2022年12月盘锦市中心医院各临床科室送检的各类标本中分离出的肠杆菌科细菌744株,均进行产ESBLs菌株检测,比较产ESBLs菌的检出情况,观察分布情况和耐药性。结果:744株菌株中,共检出产ESBLs菌121株,检出率为16.26%;其中大肠埃希菌检出率最高,依次为产气肠杆菌、肺炎克雷伯菌、阴沟肠杆菌。产ESBLs菌大肠埃希菌分布情况依次是引流液、痰液、尿液、血液、伤口及分泌物,产ESBLs菌肺炎克雷伯菌大部分分布在痰液(75.00%)。产ESBLs菌大肠埃希菌、产ESBLs菌肺炎克雷伯菌均对美罗培南敏感,对阿米卡星、阿莫西林-克拉维酸的耐药率较低,对庆大霉素、磺胺甲唑、妥布霉素的耐药性较高,对氨苄青霉素、头孢他啶、头孢噻肟的耐药率为100.00%。结论:肠杆菌科细菌中以大肠埃希菌、肺炎克雷伯菌的产ESBLs菌最为多见,主要分布在痰液、引流液、尿液、血液等,且均对碳青霉烯类抗生素敏感,临床可根据药敏试验结果选择合适的抗生素,以控制医院感染事件。

Objective:To explore the clinical distribution and drug resistance of extended-spectrumβ-lactamases(ESBLs)enterobacteriaceae bacteria,so as to provide reference for the prevention and control of nosocomial infection.Methods:Seven hundred and forty-four strains of enterobacteriaceae isolated from various specimens submitted by various clinical departments of Panjin Central Hospital from July 2021 to December 2022 were selected for detection of ESBLs-producing strains.The detection of ESBLs-producing bacteria was compared,and the distribution and drug resistance were observed.Results:Out of seven hundred and forty-four strains,a total of one hundred and twenty-one ESBLs-producing strains were detected,and the detection rate was 16.26%.Escherichia coli had the highest detection rate,followed by enterobacter aerogenes,klebsiella pneumoniae and enterobacter cloacae.The distribution of ESBLs-producing escherichia coli was drainage fluid,sputum,urine,blood,wounds and secretions,and the majority of ESBLs-producing klebsiella pneumoniae was distributed in sputum(75.00%).ESBLs-producing bacteria escherichia coli and ESBLs-producing bacteria klebsiella pneumoniae were all sensitive to meropenem,and the resistance rates to amikacin and amoxicillin-clavulanic acid were low.The drug resistance to gentamicin,sulfamethoxazole and tobramycin was relatively high,and the drug resistance rate to ampicillin,ceftazidime and cefotaxime was 100.00%.Conclusion:Among enterobacteriaceae bacteria,escherichia coli and klebsiella pneumoniae ESBLs-producing bacteria are the most common,mainly distributed in sputum,drainage fluid,urine,blood,etc.All of them are sensitive to carbapenem antibiotics,and appropriate antibiotics can be selected clinically according to the results of drug susceptibility tests to control nosocomial infection events.