某传染病医院2019~2023年碳青霉烯类耐药肠杆菌菌种分布与耐药分析

The Analysis of Distribution and Drug Resistance of Carbapenem-resistant Enterobacter Strains in an Infectious Disease Hospital From 2019 to 2023

目的分析本院2019~2023年碳青霉烯类耐药肠杆菌(Carbapenem-resistant enterobacter,CRE)菌种分布与耐药情况,以期更好地指导临床用药,为医院多重耐药菌的感控工作提供依据。方法收集本院2019~2023年临床分离的CRE菌株及患者信息,回顾性分析其菌种分布及耐药特点。结果本院2019~2023年CRE占比肠杆菌的检出率分别为16.44%、27.91%、41.11%、38.35%、42.55%,整体呈上升趋势。CRE菌株中检出率最高的依次为CRKP、CREC、CRECL。从标本来源看,占比最多的标本类型为痰、腹水和血,从年龄分布看,40~70岁的中老年人占比较高,0~60岁,占比呈上升趋势,60岁以上,呈下降趋势。3种菌对厄他培南的耐药率高于亚胺培南和美罗培南,对多粘菌素和替加环素的耐药率较低,且抗菌药物耐药谱存在差异。结论传染病医院CRE检出率更高,临床分布存在标本类型、患者年龄的差异,不同菌株耐药谱也存在差异。医院应持续性开展细菌耐药监测工作,制定有效地预防控制措施,以减少耐药菌传播。

Objective To analyze the strain distribution and drug resistance of Carbapenem-resistant enterobacter(CRE)in an infectious disease hospital from 2019 to 2023,in order to better guide clinical drug usage and to provide data-driven evidence for the control of multi-drug resistant bacteria in the hospital.Methods The clinical isolated CRE strains and patient information during 2019-2023 were collected,and the strain distribution and drug resistance characteristics were retrospectively analyzed.Results From 2019 to 2023,the detection rates of CRE in enterobacter were 16.44%,27.91%,41.11%,38.35%and 42.55%,respectively,showing an overall upward trend.Among all CRE strains,the highest detection rates were CRKP,CREC and CRECL.From the perspective of specimen sources,sputum,ascites and blood accounted for the largest proportion of specimens.From the perspective of age distribution,the proportion of middle-aged and elderly people between 40 and 70 years old was relatively high,while the proportion of 0-60 years old was increasing,and the proportion of over 60 years old was decreasing.The resistance rates of the three strains to ertapenem were higher than that of imipenem and meropenem,while the resistance rates to polymyxin and tigacycline were lower,and the antimicrobial resistance spectrum was different.Conclusion The detection rate of CRE in infectious diseases hospitals is relatively higher,and there are differences in clinical distribution of specimen type and patient age.The drug resistance spectra of different strains are also different.Hospitals should continue to reinforce bacterial resistance monitoring and develop effective prevention and control measures to reduce the spread of drug-resistant bacteria.