發(fā)布時(shí)間：2019-01-24 08:24

【摘要】：目的分析耐碳青霉烯類腸桿菌(CRE)的耐藥性及臨床分布特征,為臨床治療提供依據(jù)。方法回顧性分析2010-2014年分離出的104株非重復(fù)CRE耐藥性,采用VITEK-2全自動(dòng)分析儀等對(duì)菌株進(jìn)行鑒定及藥敏試驗(yàn),用WHONET 5.6軟件和SPSS 22.0軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì)分析。結(jié)果 2010-2014年臨床共分離病原菌19 436株,其中腸桿菌4 284株,檢出率22.0%,CRE檢出數(shù)逐年增加,共檢出104株,其檢出率為2.4%,CRE中最多的是肺炎克雷伯菌占52.9%;CRE對(duì)氨芐西林、美羅培南等11種抗菌藥物保持高耐藥率(85.0%~100.0%),對(duì)頭孢哌酮/舒巴坦、亞胺培南耐藥率隨時(shí)間增加,對(duì)頭孢他啶及磺胺甲VA唑/甲氧芐啶的耐藥率隨時(shí)間降低;CRE在ICU的檢出率為12.1%,顯著高于非ICU的2.1%,差異有統(tǒng)計(jì)學(xué)意義(P0.05);肺炎克雷伯菌主要分離自痰液占57.1%、尿液占54.5%、血液占57.1%,90.9%的褪色沙雷菌分離自痰液標(biāo)本。結(jié)論 CRE耐藥性嚴(yán)重,應(yīng)及時(shí)采取措施防止該類耐藥菌株引起大范圍播散流行。
[Abstract]:Objective to analyze the drug resistance and clinical distribution of penicillin-resistant Enterobacter carbene (CRE) in order to provide evidence for clinical treatment. Methods the drug resistance of 104 non-repeated CRE strains isolated from 2010 to 2014 were analyzed retrospectively. The strains were identified and tested by VITEK-2 automatic analyzer, and the data were statistically analyzed by WHONET 5.6 and SPSS 22.0 software. Results from 2010 to 2014, 19 436 strains of pathogenic bacteria were isolated, among which 4 284 strains were Enterobacter spp. The detectable rate of CRE increased year by year, 104 strains were detected, and the detection rate was 2.4%. Klebsiella pneumoniae accounted for 52.9% in CRE. CRE maintained high resistance to ampicillin and meropenem (85.0%), and to cefoperazone / sulbactam and imipenem increased with time. The resistance to ceftazidime and sulfamethoxazole / trimethoprim decreased with time. The positive rate of CRE in ICU was significantly higher than that in non-ICU (P 0.05). Klebsiella pneumoniae was mainly isolated from sputum (57.1%), urine (54.5%), blood (57.1%) and Shareh (90.9%) from sputum. Conclusion the drug resistance of CRE is serious, and measures should be taken in time to prevent the spread of the drug resistant strains.
【作者單位】： 北京大學(xué)第一醫(yī)院檢驗(yàn)科;北京大學(xué)腫瘤醫(yī)院檢驗(yàn)科;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(81201338)
【分類號(hào)】：R446.5

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