2010-2014年耐碳青霉烯类肠杆菌的耐药性分析

发布时间：2019-01-24 08:24

【摘要】：目的分析耐碳青霉烯类肠杆菌(CRE)的耐药性及临床分布特征,为临床治疗提供依据。方法回顾性分析2010-2014年分离出的104株非重复CRE耐药性,采用VITEK-2全自动分析仪等对菌株进行鉴定及药敏试验,用WHONET 5.6软件和SPSS 22.0软件进行数据统计分析。结果 2010-2014年临床共分离病原菌19 436株,其中肠杆菌4 284株,检出率22.0%,CRE检出数逐年增加,共检出104株,其检出率为2.4%,CRE中最多的是肺炎克雷伯菌占52.9%;CRE对氨苄西林、美罗培南等11种抗菌药物保持高耐药率(85.0%~100.0%),对头孢哌酮/舒巴坦、亚胺培南耐药率随时间增加,对头孢他啶及磺胺甲VA唑/甲氧苄啶的耐药率随时间降低;CRE在ICU的检出率为12.1%,显著高于非ICU的2.1%,差异有统计学意义(P0.05);肺炎克雷伯菌主要分离自痰液占57.1%、尿液占54.5%、血液占57.1%,90.9%的褪色沙雷菌分离自痰液标本。结论 CRE耐药性严重,应及时采取措施防止该类耐药菌株引起大范围播散流行。
[Abstract]:Objective to analyze the drug resistance and clinical distribution of penicillin-resistant Enterobacter carbene (CRE) in order to provide evidence for clinical treatment. Methods the drug resistance of 104 non-repeated CRE strains isolated from 2010 to 2014 were analyzed retrospectively. The strains were identified and tested by VITEK-2 automatic analyzer, and the data were statistically analyzed by WHONET 5.6 and SPSS 22.0 software. Results from 2010 to 2014, 19 436 strains of pathogenic bacteria were isolated, among which 4 284 strains were Enterobacter spp. The detectable rate of CRE increased year by year, 104 strains were detected, and the detection rate was 2.4%. Klebsiella pneumoniae accounted for 52.9% in CRE. CRE maintained high resistance to ampicillin and meropenem (85.0%), and to cefoperazone / sulbactam and imipenem increased with time. The resistance to ceftazidime and sulfamethoxazole / trimethoprim decreased with time. The positive rate of CRE in ICU was significantly higher than that in non-ICU (P 0.05). Klebsiella pneumoniae was mainly isolated from sputum (57.1%), urine (54.5%), blood (57.1%) and Shareh (90.9%) from sputum. Conclusion the drug resistance of CRE is serious, and measures should be taken in time to prevent the spread of the drug resistant strains.
【作者单位】：北京大学第一医院检验科;北京大学肿瘤医院检验科;
【基金】：国家自然科学基金资助项目(81201338)
【分类号】：R446.5

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