本文選題：腸桿菌科細(xì)菌 + 碳青霉烯類耐藥　； 參考：《中國感染與化療雜志》2016年03期

【摘要】：目的了解上海華山醫(yī)院2014年臨床分離腸桿菌科細(xì)菌構(gòu)成及其對(duì)多黏菌素的藥物敏感性。方法收集該院2014年1-8月臨床分離的腸桿菌科細(xì)菌,藥敏試驗(yàn)采用瓊脂稀釋法,PCR擴(kuò)增blaKPC基因并行DNA測序分析,用WHONET 5.6軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果 719株腸桿菌科細(xì)菌中,主要為克雷伯菌屬(315/719,43.8%)和大腸埃希菌(219/719,30.4%)�？死撞鷮佟⒋竽c埃希菌和枸櫞酸桿菌屬細(xì)菌對(duì)多黏菌素B和多黏菌素E的耐藥率均較低(3%);腸桿菌屬細(xì)菌對(duì)多黏菌素B和多黏菌素E的耐藥率分別為10.9%和11.1%;沙雷菌屬細(xì)菌對(duì)多黏菌素B和多黏菌素E的耐藥率分別為47.5%和44.7%;摩根菌屬和變形桿菌屬細(xì)菌對(duì)多黏菌素B和多黏菌素E的耐藥率均超過90%。碳青霉烯類耐藥菌株主要見于克雷伯菌屬,其對(duì)美羅培南、厄他培南耐藥率均高于40%,但對(duì)多黏菌素B、E耐藥率分別為2.9%、2.6%;枸櫞酸桿菌屬和沙雷菌屬細(xì)菌對(duì)厄他培南的耐藥率分別為27.8%和17.9%;其他腸桿菌科細(xì)菌對(duì)碳青霉烯類的耐藥率小于10%。20.7%(149/719)的菌株blaKPC基因呈陽性,主要見于克雷伯菌屬(129/315,41.0%);7株黏質(zhì)沙雷菌和2株肺炎克雷伯菌同時(shí)對(duì)碳青霉烯類和多黏菌素耐藥。結(jié)論克雷伯菌屬、大腸埃希菌、腸桿菌屬、枸櫞酸桿菌屬等對(duì)多黏菌素仍保持著較高的敏感性。
[Abstract]:Objective to investigate the bacterial composition of Enterobacteriaceae isolated from Shanghai Huashan Hospital in 2014 and its susceptibility to polymyxin. Methods Enterobacteriaceae bacteria isolated from January to August 2014 in our hospital were collected. The drug sensitivity test was performed by Agar dilution PCR amplification of KPC gene and DNA sequencing, and the data were statistically analyzed by WHONET 5.6 software. Results among 719 strains of Enterobacteriaceae, Klebsiella (315 / 719) 43.8% and Escherichia coli (219 / 719) 30.4%. Klebsiella, The resistance rates of Escherichia coli and Citrate bacteria to polymyxin B and polymyxin E were lower (3%), Enterobacter spp to polymyxin B and polymyxin E were 10.9% and 11.1%, respectively, and Shareh bacteria to polymyxin B and polymyxin E were 10.9% and 11.1%, respectively. The resistant rates of myxin B and polymyxin E were 47.5% and 44.7%, respectively, and the resistance rates of the genus Morgan and Proteus to polymyxin B and polymyxin E were both more than 90%. Carbapenem resistant strains, mainly found in Klebsiella, are resistant to meropenem. The rates of resistance to ertapenem were higher than 40, but the rates of resistance to polymyxine BNE were 2.9% and 2.6, respectively; those of Citrate and Shareh were 27.8% and 17.9%, respectively; and those of other Enterobacteriaceae to carbapenem were 27.8% and 17.9%, respectively, and those of other Enterobacteriaceae bacteria to carbapenem were 27.8% and 17.9%, respectively. Those strains with a rate of less than 10.20. 7% (149 / 719) were positive for the KPC gene. It was mainly found in 7 strains of Klebsiella (129 / 315 41.0%) and 2 strains of Klebsiella pneumoniae resistant to carbapenem and polymyxin at the same time. Conclusion Klebsiella, Escherichia coli, Enterobacter, Citrate are still sensitive to polymyxin.
【作者單位】： 復(fù)旦大學(xué)附屬華山醫(yī)院抗生素研究所 衛(wèi)生部抗生素臨床藥理重點(diǎn)實(shí)驗(yàn)室;
【基金】：國家自然科學(xué)基金(81273559) 國家科技部“重大新藥創(chuàng)制”科技重大專項(xiàng)(2012ZX09303004-001)
【分類號(hào)】：R446.5

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