肠杆菌科细菌对多黏菌素的敏感性分析

发布时间：2018-06-22 07:03

本文选题：肠杆菌科细菌 + 碳青霉烯类耐药　；参考：《中国感染与化疗杂志》2016年03期

【摘要】：目的了解上海华山医院2014年临床分离肠杆菌科细菌构成及其对多黏菌素的药物敏感性。方法收集该院2014年1-8月临床分离的肠杆菌科细菌,药敏试验采用琼脂稀释法,PCR扩增blaKPC基因并行DNA测序分析,用WHONET 5.6软件对数据进行统计分析。结果 719株肠杆菌科细菌中,主要为克雷伯菌属(315/719,43.8%)和大肠埃希菌(219/719,30.4%)。克雷伯菌属、大肠埃希菌和枸橼酸杆菌属细菌对多黏菌素B和多黏菌素E的耐药率均较低(3%);肠杆菌属细菌对多黏菌素B和多黏菌素E的耐药率分别为10.9%和11.1%;沙雷菌属细菌对多黏菌素B和多黏菌素E的耐药率分别为47.5%和44.7%;摩根菌属和变形杆菌属细菌对多黏菌素B和多黏菌素E的耐药率均超过90%。碳青霉烯类耐药菌株主要见于克雷伯菌属,其对美罗培南、厄他培南耐药率均高于40%,但对多黏菌素B、E耐药率分别为2.9%、2.6%;枸橼酸杆菌属和沙雷菌属细菌对厄他培南的耐药率分别为27.8%和17.9%;其他肠杆菌科细菌对碳青霉烯类的耐药率小于10%。20.7%(149/719)的菌株blaKPC基因呈阳性,主要见于克雷伯菌属(129/315,41.0%);7株黏质沙雷菌和2株肺炎克雷伯菌同时对碳青霉烯类和多黏菌素耐药。结论克雷伯菌属、大肠埃希菌、肠杆菌属、枸橼酸杆菌属等对多黏菌素仍保持着较高的敏感性。
[Abstract]:Objective to investigate the bacterial composition of Enterobacteriaceae isolated from Shanghai Huashan Hospital in 2014 and its susceptibility to polymyxin. Methods Enterobacteriaceae bacteria isolated from January to August 2014 in our hospital were collected. The drug sensitivity test was performed by Agar dilution PCR amplification of KPC gene and DNA sequencing, and the data were statistically analyzed by WHONET 5.6 software. Results among 719 strains of Enterobacteriaceae, Klebsiella (315 / 719) 43.8% and Escherichia coli (219 / 719) 30.4%. Klebsiella, The resistance rates of Escherichia coli and Citrate bacteria to polymyxin B and polymyxin E were lower (3%), Enterobacter spp to polymyxin B and polymyxin E were 10.9% and 11.1%, respectively, and Shareh bacteria to polymyxin B and polymyxin E were 10.9% and 11.1%, respectively. The resistant rates of myxin B and polymyxin E were 47.5% and 44.7%, respectively, and the resistance rates of the genus Morgan and Proteus to polymyxin B and polymyxin E were both more than 90%. Carbapenem resistant strains, mainly found in Klebsiella, are resistant to meropenem. The rates of resistance to ertapenem were higher than 40, but the rates of resistance to polymyxine BNE were 2.9% and 2.6, respectively; those of Citrate and Shareh were 27.8% and 17.9%, respectively; and those of other Enterobacteriaceae to carbapenem were 27.8% and 17.9%, respectively, and those of other Enterobacteriaceae bacteria to carbapenem were 27.8% and 17.9%, respectively. Those strains with a rate of less than 10.20. 7% (149 / 719) were positive for the KPC gene. It was mainly found in 7 strains of Klebsiella (129 / 315 41.0%) and 2 strains of Klebsiella pneumoniae resistant to carbapenem and polymyxin at the same time. Conclusion Klebsiella, Escherichia coli, Enterobacter, Citrate are still sensitive to polymyxin.
【作者单位】：复旦大学附属华山医院抗生素研究所卫生部抗生素临床药理重点实验室;
【基金】：国家自然科学基金(81273559) 国家科技部“重大新药创制”科技重大专项(2012ZX09303004-001)
【分类号】：R446.5

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