血标本来源的广泛耐药革兰阴性菌的流行病学分析

发布时间：2019-08-13 10:02

【摘要】：目的探讨血标本来源耐碳青霉烯大肠埃希菌(CREC)、肺炎克雷伯菌(CRKP),广泛耐药铜绿假单胞菌(XDRPA)、鲍曼不动杆菌(XDRAB)的地理分布和可用抗菌药物的最小抑菌浓度(MIC)分布。方法 2013年国内主要地区208所综合医院收集来自血标本大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌临床分离株共24113株。采用自动化仪器法检测抗菌药物MIC。统计分析4种耐药株检出率与地理分布、临床科室来源、不同年龄组人群来源相关性。结果 CREC、CRKP、XDRPA和XDRAB平均检出率分别为1.0%,5.5%,4.2%和13.7%。除CREC,余耐药菌地理区域差异性明显。儿童CRKP和XDRAB检出率最高,分别为10.6%和13.1%。ICU科室各菌株检出率均较高。55.8%CREC和22.9%CRKP亚胺培南MIC值≤4μg/m L,97.4%的XDRAB和84%的XDRPA为对亚胺培南MIC≥16μg/m L。所有CREC,CRKP和81.2%的XDRAB对替加环素敏感,其MIC90分别为0.5,2和4μg/m L。结论我国血标本来源的CRKP和XDRAB在各地均有检出,尤以儿童组和ICU科室较明显。替加环素对CRKP,CRE和XDRAB保持较高敏感性。
[Abstract]:Objective to investigate the geographical distribution and minimum inhibitory concentration (MIC) distribution of Acinetobacter baumannii (XDRAB), Pseudomonas aeruginosa (CRKP), widely resistant to carbapenem-resistant Escherichia coli (CREC), Klebsiella pneumoniae (Klebsiella pneumoniae) and Acinetobacter baumannii (Acinetobacter baumannii). Methods 24113 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were collected from 208 general hospitals in China in 2013. Detection of Antibacterial MIC. by automatic instrument method The correlation between the detection rate of four drug-resistant strains and geographical distribution, the source of clinical department and the source of different age groups was statistically analyzed. Results the average detection rates of CREC,CRKP,XDRPA and XDRAB were 1.0%, 5.5%, 4.2% and 13.7%, respectively. The geographical difference of drug-resistant bacteria except CREC, was obvious. The detection rates of CRKP and XDRAB in children were the highest (10.6%) and those in 13.1%.ICU department were higher. 55.8% CREC and 22.9%CRKP imipenem MIC values 鈮，

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