某医院临床分离阴沟肠杆菌分布及其耐药性变迁
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摘要
目的了解某医院临床分离阴沟肠杆菌分布和耐药性变迁,指导临床合理用药。方法采用细菌鉴定和药敏试验方法,对某医院住院患者临床送检标本中检出的阴沟肠杆菌分布及其耐药性进行分析。结果临床分离阴沟肠杆菌共498株,主要来源于神经外科、重症监护室和骨科,分别占26. 10%、18. 67%和12. 65%,检出率分别为23. 13%、10. 79%和6. 66%。临床分离的病原菌主要来源于痰液、尿液和分泌物等标本,构成比依次为58. 23%、16. 67%和13. 05%。阴沟肠杆菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢吡肟、头孢他啶和碳青霉烯类的敏感率均呈现逐年下降的趋势,共检测出耐碳青霉烯菌株43株,检出率为8. 6%。结论该医院临床分离的阴沟肠杆菌对抗菌药物的耐药性呈增长趋势,对碳青霉烯类抗菌药物耐药性明显增加,应加强感染病原菌耐药性监测。
Objective To understand clinical distribution and the changes of drug resistance of Enterobacter cloacae in hospital,so as to provide basis for the clinical reasonable use of antibiotics. Methods Bacterial isolation and culture and drug sensitivity test were used to detect and analyze clinical distribution and the changes of drug resistance of Enterobacter cloacae in a hospital. Results 498 strains of Enterobacter cloacae were collected. Mainly distributed in neurosurgery,orthopaedics and ICU,accounting for 23. 13%,10. 79 % and 6. 66% respectively,the main source of specimens were sputum,urine and secretions,accounting for 58. 23 %,16. 67% and 13. 05% respectively. The sensitivity of Enterobacter cloacae to piperasilicillin/tazobatam, cefoperazolobatam, cefpime,ceftazobatam showed a decreasing trend year by year,43 strains of carbapenene drug-resistant,accounted for 8. 6%. Conclusion The resistance of Enterobacter cloacae isolated in this hospital to antimicrobial drugs is increasing,especially for carbapenem resistance increased significantly. It is necessary to strengthen drug resistance monitor.
Objective To understand clinical distribution and the changes of drug resistance of Enterobacter cloacae in hospital,so as to provide basis for the clinical reasonable use of antibiotics. Methods Bacterial isolation and culture and drug sensitivity test were used to detect and analyze clinical distribution and the changes of drug resistance of Enterobacter cloacae in a hospital. Results 498 strains of Enterobacter cloacae were collected. Mainly distributed in neurosurgery,orthopaedics and ICU,accounting for 23. 13%,10. 79 % and 6. 66% respectively,the main source of specimens were sputum,urine and secretions,accounting for 58. 23 %,16. 67% and 13. 05% respectively. The sensitivity of Enterobacter cloacae to piperasilicillin/tazobatam, cefoperazolobatam, cefpime,ceftazobatam showed a decreasing trend year by year,43 strains of carbapenene drug-resistant,accounted for 8. 6%. Conclusion The resistance of Enterobacter cloacae isolated in this hospital to antimicrobial drugs is increasing,especially for carbapenem resistance increased significantly. It is necessary to strengthen drug resistance monitor.
引文
[1]宁兴旺,朱惠斌,匡敏,等.107株阴沟肠杆菌产ESBLs和AmpC酶检测及耐药性分析[J].实用预防医学,2018,25(5).534-537.
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[4]王芳,魏任雄,张肖肖,等.产碳青霉烯酶阴沟肠杆菌耐药特性及耐药基因分析[J].中国消毒学杂志,2018,35(1):17-19.
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[8]潘恺,钱小玲,周东升,等.阴沟肠杆菌临床分布与耐药性分析[J].中华医院感染学杂志,2015,25(16):3640-3642.
[9]宁长秀,汪红,钟桥石,等.耐碳青霉烯类抗菌药物肠杆菌科细菌耐药特性的分析[J].中国抗生素杂志,2013,38(10):788-790.
[10]蔡培泉,过毅.阴沟肠杆菌痰液分离株耐药基因谱及菌株亲缘性分析[J].中华医院感染学杂志,2009,19(7):721-723.
[11]冯婷婷,王佳贺.阴沟肠杆菌感染与耐药机制的研究进展[J].中国人兽共患病学报,2017,33(10):933-937.
[2]韩清,陈群英.229株阴沟肠杆菌的标本分布及耐药性分析[J].中国微生态学杂志,2012,24(9):834-835.
[3]卢兆莲,公衍文,薛炼,等.阴沟肠杆菌的临床分布及耐药性变迁[J].中国感染与化疗杂志,2015,15(5):459-461.
[4]王芳,魏任雄,张肖肖,等.产碳青霉烯酶阴沟肠杆菌耐药特性及耐药基因分析[J].中国消毒学杂志,2018,35(1):17-19.
[5]尚红,王毓三.全国临床检验操作规程[M].第2版.江苏南京:东南大学出版社,1997:412-518.
[6]Clinical and Laboratory Standards Institute(CLSI).M100-S22Performance standards for Antimicrobial Susceptibility Testing[S].2012.
[7]张鲜惠,张亚彬,兰小鹏.905株阴沟肠杆菌的临床标本分布及耐药性分析[J].实用医学杂志,2012,28(6):991-993.
[8]潘恺,钱小玲,周东升,等.阴沟肠杆菌临床分布与耐药性分析[J].中华医院感染学杂志,2015,25(16):3640-3642.
[9]宁长秀,汪红,钟桥石,等.耐碳青霉烯类抗菌药物肠杆菌科细菌耐药特性的分析[J].中国抗生素杂志,2013,38(10):788-790.
[10]蔡培泉,过毅.阴沟肠杆菌痰液分离株耐药基因谱及菌株亲缘性分析[J].中华医院感染学杂志,2009,19(7):721-723.
[11]冯婷婷,王佳贺.阴沟肠杆菌感染与耐药机制的研究进展[J].中国人兽共患病学报,2017,33(10):933-937.