云南玉溪地区某医院碳青霉烯类耐药肠杆菌目细菌临床分布与耐药分析

Analysis on clinical distribution and drug resistance of carbapenem-resistant enterobacteriales in a hospital in Yuxi,Yunnnan Provinces

目的了解本院2018年-2021年CRE的临床分布及细菌耐药情况,指导临床合理用药,为医院多重耐药菌的感控管理工作提供依据。方法收集2018年-2021年本院临床分离的CRE菌株及患者信息,回顾性分析感染情况和临床特征及耐药特点。结果本院CRE菌株以CRKP、CREC和CRECL检出率较高;患者主要集中在重症医学科、儿科和急诊内科,以儿童和51~80岁老年人为主;呼吸道标本来源占比较高。三种细菌对亚胺培南的耐药率低于厄他培南,对替加环素敏感率高,且抗菌药物耐药谱存在一定差异。结论CRE菌株临床分布因科室、标本类型、年龄等存在差异,临床应参考药敏结果精准用药,医院应持续开展细菌耐药性监测,并以此为依据制定有效预防控制措施和进行抗生素管理,防止及减少多重耐药菌及医院内感染的发生。

Objective To understand the clinical distribution and bacterial drug resistance of CRE in our hospital from 2018 to 2021,guide clinical rational drug use,so as to provide basis for the infection control and management of multi-drug resistant bacteria in our hospital.Methods Information of clinically isolated CRE strains and patients in our hospital from 2018 to 2021 were collected,infection status,clinical characteristics and drug resistance characteristics were retrospectively analyzed.Results The detection rates of CRKP,CREC and CRECL were high in that hospital.Patients were mainly concentrated in department of ICU,pediatrics and emergency medicine,mainly children and the elderly aged 51-80 years;The source of respiratory tract specimens accounted for a higher proportion.The resistance rate of the three bacteria to imipenem was lower than ertapenem,and the sensitivity rate to tigacycline was higher,there was some differences in antimicrobial resistance spectrum.Conclusions The clinical distribution of CRE strains was different due to department,specimen type,age and so on.Clinic should refer to the drug sensitivity results for precision drug use,and the hospital should continue to carry out bacterial resistance monitoring,and develop effective prevention and control measures and antibiotic management based on this.Prevent and reduce the occurrence of multi-drug resistant bacteria and nosocomial infections.