摘要
目的了解泰州地区某医院2020年12月—2023年5月临床分离的碳青霉烯类耐药肠杆菌目细菌(carbapenem-resistant Enterobacterales,CRE)的耐药性及碳青霉烯酶表型和基因型,为泰州地区CRE的临床诊疗、抗菌药物合理应用和感控提供参考依据。方法采用VITEK2 Compact系统和纸片扩散法进行药敏试验,结果按2023年版美国临床和实验室标准协会M100标准判读,采用碳青霉烯酶抑制剂增强试验检测碳青霉烯酶表型,GeneXpert^(®)Carba-R和酶免疫层析(胶体金免疫层析法)检测碳青霉烯酶基因型,使用WHONET 2023软件和Excel 2016进行数据分析。结果收集到54株CRE,主要分离自痰液(50.0%),主要源自重症监护室(intensive care unit,ICU)(27.8%)。所分离的CRE对阿米卡星的耐药率最低(27.8%),对于除氨基糖苷类抗生素外的其他大多数抗菌药物的耐药率均超过80.0%;碳青霉烯酶表型试验检出产A类丝氨酸酶和B类金属β内酰胺酶菌株各17株,同时产A类和B类酶菌株1株;基因型检测检出KPC型菌株17株、NDM型菌株16株、IMP型菌株1株、OXA-48型菌株8株、1株菌株同时检出KPC和NDM。结论该医院所分离的CRE对部分抗菌药物的耐药率、碳青霉烯酶表型和基因型与国内外其他地区报道的数据存在一定差异,常规开展碳青霉烯酶表型或基因型检测有助于临床诊疗、抗菌药物合理应用和感控。
Objective To understand the drug resistance and carbapenemase phenotype and genotype of carbapenem-resistant Enterobacterales(CRE)clinically isolated from December 2020 to May 2023 in a hospital of Taizhou Region,and to provide a reference basis for the clinical diagnosis and treatment,rational application of antimicrobial agents and infection control of CRE in Taizhou Region.Methods The drug susceptibility testing was performed using the VITEK2 Compact system and disk diffusion test.The results were interpreted according to the 2023 edition of the American Society for Clinical and Laboratory Standards M100 standard.The carbapenemase inhibitor enhancement assay was used to detect carbapenemase phenotype,and the carbapenemase genotype was detected by GeneXpert^(®)Carba-R and enzyme immunochromatography(colloidal gold immunochromatography assay).The data were analyzed using the WHONET 2023 software and Excel 2016.Results A total of 54 strains of CRE were collected,isolated mainly form sputum(50.0%)and mainly form the intensive care unit(ICU)(27.8%).The isolated CRE showed the lowest resistance to amikacin(27.8%)and more than 80.0%drug-resistance rate to most of the other antimicrobial agents except aminoglycoside antibiotics.Carbapenemase phenotypic test detected 17 strains of class A serine enzyme and 17 strains of class B metallo-β-lactamase,and 1 strain of both class A and class B enzymes.Genotypic test detected 17 strains of the KPC type,16 strains of the NDM type,1 strain of the IMP type,8 strains of the OXA-48 type,and 1 strain of both KPC and NDM.Conclusion The resistance rate to some antimicrobial agents,carbapenemase phenotypes and genotypes of CRE isolated in this hospital have some discrepancies in the data reported in other regions at home and abroad.Detection of carbapenemase phenotype and genotype is routinely performed to facilitate clinical diagnosis and treatment,rational application of antimicrobial agents and infection control.
作者
罗欲承
王芬
赵秋霞
庄严
陈燕
LUO Yucheng;WANG Fen;ZHAO Qiuxia;ZHUANG Yan;CHEN Yan(Department of Clinical Laboratory,Xinghua City People's Hospital,Xinghua,Jiangsu 225700,China;不详)
出处
《医学动物防制》
2025年第2期205-208,F0003,共5页
Journal of Medical Pest Control
基金
江苏大学临床医学科技发展基金项目(JLY2021199)
江苏医药职业学院临床教学基地科研发展专项课题(20219137)。
