东莞地区耐碳青霉烯类肠杆菌科细菌的临床分布及耐药性

发布时间：2018-06-27 07:52

本文选题：耐碳青霉烯类肠杆菌 + 抗菌药物　；参考：《中国感染控制杂志》2017年11期

【摘要】：目的了解东莞地区耐碳青霉烯类肠杆菌科细菌(CRE)的临床分布及其耐药性。方法回顾性分析2015年1月—2016年6月东莞市22所二级甲等及以上参加细菌耐药监测的医疗机构的住院患者分离的CRE菌株,应用WHONET5.6软件进行耐药性分析。结果共检出CRE71株,检出率0.34%(71/20 713)。CRE来源患者主要为15~60岁(53株,74.65%);男性(46株,64.79%);来源科室主要为重症监护病房(36株,50.70%);来源标本主要为痰(34株,47.89%),其次为尿(11株,15.49%)、伤口分泌物(6株,8.45%);感染类型主要为医院感染(64株,90.14%);主要来源于三级医院(56株,78.87%)。三级医院CRE检出率为0.41%(56/13 677),二级医院为0.21%(15/7 036)。71株CRE对亚胺培南均耐药,对美罗培南耐药率81.12%,耐药率40%的药物仅有阿米卡星(21.38%)和妥布霉素(38.79%),对复方磺胺甲口恶唑的耐药率为48.23%,而对氟喹诺酮类、第三代头孢菌素及其含酶抑制剂等药物的耐药率均超过60%。结论东莞地区医疗机构CRE检出率低于全国及其他省份,应针对CRE检出的重点人群、科室采取有效预防控制措施,合理使用抗菌药物。
[Abstract]:Objective to investigate the clinical distribution and drug resistance of Enterobacteriaceae (CRE) resistant to carbapenem in Dongguan area. Methods from January 2015 to June 2016, the CRE strains isolated from 22 medical institutions participating in bacterial resistance monitoring were analyzed retrospectively, and the drug resistance was analyzed by WHONET5.6 software. Results CRE71 strains were detected. The detection rate of CRE was 0.34% (71 / 20 713). The patients from CRE were 150-60 years old (53 strains, 74.65%), males (46 strains, 64.79%), intensive care units (36 strains, 50.70%), sputum (34 strains, 47.89%), urine (11 strains, 15.49%), wound secretions (6 strains, 8.45%), the main types of infection were sputum (34 strains, 47.89%), urine (11 strains, 15.49%), wound secretion (6 strains, 8.45%). Nosocomial infection (64 strains, 90.14%), mainly from tertiary hospitals (56 strains, 78.87%). The detection rate of CRE in tertiary hospitals was 0.41% (56 / 13 677), and 0.21% (15 / 7 036). 71 strains of CRE were resistant to imipenem. The resistance rate to meropenem was 81.12%, only amikacin (21.38%) and tobramycin (38.79%) were found in 40% of the drugs. The resistance rate to compound sulfamethoxazole was 48.23%, but to fluoroquinolones, the third generation cephalosporins and their enzyme inhibitors, the drug resistance rate exceeded 605%. Conclusion the detection rate of CRE in medical institutions in Dongguan is lower than that in the whole country and other provinces. The department should take effective preventive measures and rational use of antimicrobial agents for the key population detected by CRE.
【作者单位】：中山大学附属东华医院;
【基金】：2015年度中华医院感染控制研究基金(ZHYY2015-0015)
【分类号】：R446.5

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