肠杆菌科细菌耐药性及其耐碳青霉烯类菌株分布特点

发布时间：2018-03-31 01:14

本文选题：肠杆菌科细菌　切入点：抗菌药物　出处：《中国感染控制杂志》2017年02期

【摘要】：目的了解2015年度西京医院肠杆菌科细菌耐药性,以及耐碳青霉烯类肠杆菌科细菌的分布特点,为临床合理应用抗菌药物提供依据。方法对2015年1—12月西京医院住院及门诊患者临床感染标本进行病原菌培养、分离和鉴定,采用K-B纸片扩散法进行药敏试验,采用改良Hodge方法进行碳青霉烯酶确证试验,统计肠杆菌科细菌耐药情况。结果 2015年共检出病原菌4 166株,肠杆菌科细菌1 554株,分离率为37.30%,其中大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、奇异变形杆菌及产气肠杆菌位列肠杆菌科细菌的前5位。787株大肠埃希菌中产ESBLs菌株581株,产酶率为73.82%;367株肺炎克雷伯菌中产ESBLs菌株182株,产酶率为49.59%。大肠埃希菌、肺炎克雷伯菌对头孢唑林耐药率最高,分别为93.14%、78.48%。共检出耐碳青霉烯类抗生素肠杆菌科细菌81株,分离率为5.21%,其中肺炎克雷伯菌41株,阴沟肠杆菌27株,大肠埃希菌13株;主要来自神经外科(42株),消化内科(9株),神经内科(8株)。1.02%(8/787)的大肠埃希菌、3.27%(12/367)的肺炎克雷伯菌具有多重耐药性。结论医院感染病原菌中肠杆菌科细菌所占比例较高,肠杆菌科细菌产ESBLs菌株的检出率较高,耐碳青霉烯类抗生素肠杆菌科细菌分离率较去年有所上升,尤以肺炎克雷伯菌显著。
[Abstract]:Objective to investigate the drug resistance of Enterobacteriaceae in Xijing Hospital in 2015 and the distribution of carbapene-resistant Enterobacteriaceae. Methods the pathogenic bacteria were cultured, isolated and identified in clinical infection samples of hospitalized and outpatient patients in Xijing Hospital from January to December 2015, and the susceptibility test was carried out by K-B disk diffusion method. A modified Hodge method was used to determine the resistance of Enterobacteriaceae bacteria. Results in 2015, 4 166 strains of pathogenic bacteria and 1 554 strains of Enterobacteriaceae were detected, the isolation rate was 37.30%, among which Escherichia coli and Klebsiella pneumoniae were detected. Enterobacter cloacae, Proteus mirabilis and Enterobacter aerogenes were among the top 5 strains of Enterobacteriaceae. Among them, 581 strains of Escherichia coli produced ESBLs, and the rate of producing enzyme was 73.82%. 182 strains of Klebsiella pneumoniae and 49.59% of Escherichia coli were produced by Enterobacter cloacae, Proteus mirabilis and Enterobacter aerogenes. The resistant rate of Klebsiella pneumoniae to cefazolin was 93.148.48, respectively. 81 strains of Enterobacteriaceae were found to be resistant to carbapenem, and the isolation rate was 5.21%, including 41 strains of Klebsiella pneumoniae, 27 strains of Enterobacter cloacae and 13 strains of Escherichia coli. 42 strains of Klebsiella pneumoniae from neurosurgical department, 9 strains from digestive department and 8 strains from 8 / 787 strains of neurology were found to have multidrug resistance in Klebsiella pneumoniae. Conclusion the proportion of enterobacteriaceae bacteria in nosocomial infection is higher than that of enterobacteriaceae in nosocomial infection. The detection rate of Enterobacteriaceae strains producing ESBLs was higher than that of last year, especially Klebsiella pneumoniae. The isolation rate of Enterobacteriaceae strains resistant to carbapenem antibiotics was higher than that of last year, especially Klebsiella pneumoniae.
【作者单位】：第四军医大学西京医院;
【基金】：陕西省自然科学基础研究计划项目(2014)
【分类号】：R446.5

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