论文部分内容阅读
目的了解东莞地区耐碳青霉烯类肠杆菌科细菌(CRE)的临床分布及其耐药性。方法回顾性分析2015年1月—2016年6月东莞市22所二级甲等及以上参加细菌耐药监测的医疗机构的住院患者分离的CRE菌株,应用WHONET5.6软件进行耐药性分析。结果共检出CRE71株,检出率0.34%(71/20 713)。CRE来源患者主要为15~60岁(53株,74.65%);男性(46株,64.79%);来源科室主要为重症监护病房(36株,50.70%);来源标本主要为痰(34株,47.89%),其次为尿(11株,15.49%)、伤口分泌物(6株,8.45%);感染类型主要为医院感染(64株,90.14%);主要来源于三级医院(56株,78.87%)。三级医院CRE检出率为0.41%(56/13 677),二级医院为0.21%(15/7 036)。71株CRE对亚胺培南均耐药,对美罗培南耐药率81.12%,耐药率<40%的药物仅有阿米卡星(21.38%)和妥布霉素(38.79%),对复方磺胺甲口恶唑的耐药率为48.23%,而对氟喹诺酮类、第三代头孢菌素及其含酶抑制剂等药物的耐药率均超过60%。结论东莞地区医疗机构CRE检出率低于全国及其他省份,应针对CRE检出的重点人群、科室采取有效预防控制措施,合理使用抗菌药物。
Objective To investigate the clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae (CRE) in Dongguan area. Methods A retrospective analysis of CRE isolates from hospitalized patients of 22 Grade A and above Grade A and above medical institutions in Dongguan City from January 2015 to June 2016 was conducted and analysis of drug resistance was performed using WHONET5.6 software. Results A total of 67 strains of CRE71 were detected with a detection rate of 0.34% (71/20 713). The main source of CRE was 15-60 years old (53 strains, 74.65%); male (46 strains, 64.79%); the main source of the ICU was ICU (36 strains, 50.70% 47.89%), followed by urine (11 strains, 15.49%) and wound secretions (6 strains, 8.45%). The main types of infection were nosocomial infections (64, 90.14% 78.87%). The detection rate of CRE in tertiary hospitals was 0.41% (56/13 677) and in secondary hospitals 0.21% (15/7 036). 71 CRE were resistant to imipenem, the rate of drug resistance to meropenem was 81.12%, only amikacin (21.38%) and tobramycin (38.79%) were resistant to drug resistance rate <40% The resistance rate of compound sulfamethoxazole was 48.23%, while the resistance rates to fluoroquinolones, third generation cephalosporins and its inhibitors containing enzymes were over 60%. Conclusion The detection rate of CRE in medical institutions in Dongguan is lower than that in the whole country and other provinces. Effective prevention and control measures should be taken for the key populations detected by CRE, and rational use of antimicrobial agents should be taken.