本文選題：耐碳青霉烯類(lèi)腸桿菌 + 抗菌藥物　； 參考：《中國(guó)感染控制雜志》2017年11期

【摘要】：目的了解東莞地區(qū)耐碳青霉烯類(lèi)腸桿菌科細(xì)菌(CRE)的臨床分布及其耐藥性。方法回顧性分析2015年1月—2016年6月東莞市22所二級(jí)甲等及以上參加細(xì)菌耐藥監(jiān)測(cè)的醫(yī)療機(jī)構(gòu)的住院患者分離的CRE菌株,應(yīng)用WHONET5.6軟件進(jìn)行耐藥性分析。結(jié)果共檢出CRE71株,檢出率0.34%(71/20 713)。CRE來(lái)源患者主要為15~60歲(53株,74.65%);男性(46株,64.79%);來(lái)源科室主要為重癥監(jiān)護(hù)病房(36株,50.70%);來(lái)源標(biāo)本主要為痰(34株,47.89%),其次為尿(11株,15.49%)、傷口分泌物(6株,8.45%);感染類(lèi)型主要為醫(yī)院感染(64株,90.14%);主要來(lái)源于三級(jí)醫(yī)院(56株,78.87%)。三級(jí)醫(yī)院CRE檢出率為0.41%(56/13 677),二級(jí)醫(yī)院為0.21%(15/7 036)。71株CRE對(duì)亞胺培南均耐藥,對(duì)美羅培南耐藥率81.12%,耐藥率40%的藥物僅有阿米卡星(21.38%)和妥布霉素(38.79%),對(duì)復(fù)方磺胺甲口惡唑的耐藥率為48.23%,而對(duì)氟喹諾酮類(lèi)、第三代頭孢菌素及其含酶抑制劑等藥物的耐藥率均超過(guò)60%。結(jié)論東莞地區(qū)醫(yī)療機(jī)構(gòu)CRE檢出率低于全國(guó)及其他省份,應(yīng)針對(duì)CRE檢出的重點(diǎn)人群、科室采取有效預(yù)防控制措施,合理使用抗菌藥物。
[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.
【作者單位】： 中山大學(xué)附屬東華醫(yī)院;
【基金】：2015年度中華醫(yī)院感染控制研究基金(ZHYY2015-0015)
【分類(lèi)號(hào)】：R446.5

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