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

【摘要】：目的了解東莞地區(qū)耐碳青霉烯類腸桿菌科細菌(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所二級甲等及以上參加細菌耐藥監(jiān)測的醫(yī)療機構(gòu)的住院患者分離的CRE菌株,應(yīng)用WHONET5.6軟件進行耐藥性分析。結(jié)果共檢出CRE71株,檢出率0.34%(71/20 713)。CRE來源患者主要為15~60歲(53株,74.65%);男性(46株,64.79%);來源科室主要為重癥監(jiān)護病房(36株,50.70%);來源標(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%);感染類型主要為醫(yī)院感染(64株,90.14%);主要來源于三級醫(yī)院(56株,78.87%)。三級醫(yī)院CRE檢出率為0.41%(56/13 677),二級醫(yī)院為0.21%(15/7 036)。71株CRE對亞胺培南均耐藥,對美羅培南耐藥率81.12%,耐藥率40%的藥物僅有阿米卡星(21.38%)和妥布霉素(38.79%),對復(fù)方磺胺甲口惡唑的耐藥率為48.23%,而對氟喹諾酮類、第三代頭孢菌素及其含酶抑制劑等藥物的耐藥率均超過60%。結(jié)論東莞地區(qū)醫(yī)療機構(gòu)CRE檢出率低于全國及其他省份,應(yīng)針對CRE檢出的重點人群、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)
【分類號】：R446.5

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