摘要
目的分析耐碳青霉烯类肠杆菌(CRE)流行病学特征与耐药性。方法对2014年1月至2019年12月东莞市人民医院83株耐碳青霉烯类抗生素的肠杆菌科菌种进行菌种鉴定、药敏分析及对占比最高的肺炎克雷伯菌进行常见的碳青霉烯酶基因检测,分析CRE菌株来源、菌种分布、碳青霉烯酶基因分布及耐药性。结果83株标本中来自尿液、痰液、血液的CRE菌株占比最高,三种途径菌株共计64株;83株CRE当中肺炎克雷伯菌(36株)、大肠埃希菌(20株)、阴沟肠杆菌(14株)占比最高,三种病原菌共计70株(84.34%)。选择占比最多的肺炎克雷伯菌进行耐药基因检测,分别检测了KPC、IMP、VIM、OXA等。36株耐碳青霉烯类肺炎克雷伯菌中检出携带碳青霉烯酶基因的菌株共31株,检出率为86.11%(31/36),其中检出率最高的碳青霉烯酶基因为KPC,检出率为83.33%;耐药性分析结果显示对CRE敏感率最高的三种抗菌药物为阿米卡星、庆大霉素、呋喃妥因,敏感率分别为69.88%、37.35%、37.35%。结论KPC基因是检出率最高的碳青霉烯酶基因,而阿米卡星、庆大霉素、呋喃妥因对CRE敏感率分别达到69.88%、37.35%、37.35%,以上三种抗菌药物对临床CRE感染治疗具有积极意义。
Objective To analyze the epidemiological characteristics and drug resistance of carbapenem-resistant Enterobacteriaceae(CRE).Methods From January 2014 to December 2019,a total of 83 strains of Enterobacteriaceae resistant to carbapenem antibiotics in Dongguan People’s Hospital were identified,their drug sensitivity was analyzed,and the common carbapenemase gene of Klebsiella pneumoniae,which accounted for the highest proportion,was detected.The origin,distribution of CRE strains,distribution of carbapenemase gene and drug resistance were analyzed.Results The CRE strains from urine,sputum and blood accounted for the highest proportion of 83 CRE specimens,with 64 strains from the three sources.Among 83 CRE strains,Klebsiella pneumoniae(36 strains),Escherichia coli(20 strains)and Enterobacter cloacae(14 strains)accounted for the highest proportion,with a total of 70 strains(84.34%).Klebsiella pneumoniae,which accounted for the largest proportion,was selected for drug resistance gene detection,and KPC,IMP,VIM,OXA,etc.were detected.Among 36 carbapenem-resistant Klebsiella pneumoniae strains,31 strains carrying carbapenemase gene were detected,with the detection rate of 86.11%(31/36),and the highest detection rate was KPC(with the detection rate of 83.33%).The drug resistance analysis showed that amikacin,gentamicin and nitrofurantoin were the three antibiotics with the highest sensitivity to CRE,and the sensitivity was 69.88%,37.35%and 37.35%,respectively.Conclusion KPC gene is the carbapenemase gene with the highest detection rate,and the sensitivity of amikacin,gentamicin and nitrofurantoin to CRE is 69.88%,37.35%and 37.35%,respectively.The above three antibiotics have positive significance for clinical treatment of CRE infection.
作者
李少媚
吴森泉
张嘉文
赖应昌
黎雪晶
姜义荣
LI Shaomei;WU Senquan;ZHANG Jiawen;LAI Yingchang;LI Xuejing;JIANG Yirong(Department of Hematologic Lymphoma,Dongguan People’s Hospital,Guangdong,Dongguan 523000,China;Department of Respiratory and Critical Care Medicine,Dongguan People’s Hospital,Guangdong,Dongguan 523000,China;Department of Laboratory Medicine,Dongguan People’s Hospital,Guangdong,Dongguan 523000,China)
出处
《中国医药科学》
2022年第4期138-141,共4页
China Medicine And Pharmacy
基金
广东省东莞市社会科技发展项目(202050715001774
202050715001563)。
关键词
耐碳青霉烯类肠杆菌
抗菌药物
耐药性
流行病学
Carbapenem-resistant Enterobacteriaceae
Antibiotics
Drug resi stance
Epidemiology
