烧伤科患者肠杆菌科细菌耐药性与基因型分布

发布时间：2018-03-14 20:33

本文选题：医院感染　切入点：烧伤科　出处：《中华医院感染学杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的了解烧伤科患者肠杆菌科细菌分布、耐药性及基因型分布,为临床抗感染治疗提供依据。方法分析2010年1月-2014年12月烧伤科患者送检标本类型、分离的肠杆菌科细菌及药敏结果,抽取2013年分离的106株肠杆菌科细菌进行ESBLs和AmpC酶表型确认试验,并利用PCR技术检测ESBLs和AmpC酶等耐药基因,对初筛亚胺培南的菌株进行改良Hodge试验及EDTA协同抑制试验,并对碳青霉烯酶耐药基因进行检测。结果 2010-2014年烧伤科患者共分离出肠杆菌科细菌568株,标本来源主要以脓液及分泌物为主占90.1%;分离菌中以阴沟肠杆菌、大肠埃希菌和肺炎克雷伯菌为主,分别占33.5%、23.1%和15.7%;肠杆菌科细菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦、头孢吡肟和头孢替坦等保持了较低的耐药率,肠杆菌科细菌中ESBLs和AmpC酶表型阳性率分别为30.2%和8.5%,基因型阳性率分别为34.0%和24.5%。结论烧伤科患者肠杆菌科细菌耐药性仍较为严重,医护人员需严格无菌操作,防止医院感染的发生。
[Abstract]:Objective to investigate the distribution of Enterobacteriaceae bacteria, drug resistance and genotypes of enterobacteriaceae from January 2010 to December 2014 in order to provide evidence for clinical anti-infective therapy. Methods from January 2010 to December 2014, the types of specimens of enterobacteriaceae were analyzed. In 2013, 106 strains of Enterobacteriaceae strains isolated from the family Enterobacteriaceae were selected for ESBLs and AmpC enzyme phenotypic identification tests, and ESBLs and AmpC resistant genes were detected by PCR technique. The strains of imipenem were tested by modified Hodge test and EDTA co-inhibition test. Results 568 strains of Enterobacteriaceae were isolated from patients with burn from 2010 to 2014. The samples were mainly from pus and secretions (90.1%), Enterobacter cloacae, Escherichia coli and Klebsiella pneumoniae were the main isolates, accounting for 33.52.1% and 15.70.Enterobacteriaceae was responsible for imipenem, amikacin, piperacillin / tazobactam. Cefepime and cefetitan maintained a low drug resistance rate. The phenotype positive rates of ESBLs and AmpC in Enterobacteriaceae were 30.2% and 8.5, respectively, and the positive rates of genotype were 34.0% and 24.50.Conclusion the drug resistance of Enterobacteriaceae in burn patients is still serious. Medical staff should be strictly sterile to prevent nosocomial infection.
【作者单位】：宁夏医科大学总医院医学实验中心;宁夏临床病原微生物重点实验室;宁夏医科大学检验学院;
【基金】：宁夏自然科学基金资助项目(NZ1233,N215278) 宁夏医科大学基金资助项目(XM201464,XM2015092,XM2014116)
【分类号】：R644;R446.5

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