摘要
目的分析北京大学首钢医院近5年耐碳青霉烯类肠杆菌科细菌(carbapenem-resistant Enterobacteriaceae,CRE)的临床分布特征和耐药变迁。方法收集北京大学首钢医院2016年1月至2020年12月期间临床分离的CRE菌株,分析其临床分布特征和药敏结果,采用WHONET 5.6软件进行数据分析。结果5年间我院共检出CRE菌株1263株,总检出率为7.2%,且各年度检出率呈逐年上升的趋势。其中分离前三位的是肺炎克雷伯菌(86.0%)、大肠埃希菌(10.6%)和阴沟肠杆菌(2.4%)。标本来源占比最大为呼吸道标本,占比为59.5%,其次是尿液标本和血液标本,分别占比19.4%和13.6%。CRE菌株科室分布前三位是重症监护室(32.6%)、呼吸监护室(19.4%)和呼吸科(19.0%),检出率前三位的是重症监护室(18.1%)、呼吸监护室(17.9%)和急诊科(15.8%)。CRE感染患者以年龄>60岁以上者为多,占比高达93.2%。CRE对头孢菌素、青霉素、喹诺酮类平均耐药率可达90.0%以上,对庆大霉素、阿米卡星和复方磺胺甲噁唑的耐药率相对较低,为81.0%、62.3%和46.2%,对粘菌素的耐药率最低,为3.5%。结论我院CRE感染呈逐年上升趋势,耐药情况严重,临床应采取积极有效的感染防控措施。
Objective To analyze the clinical distribution characteristics and drug resistance pattern of carbapenem-resistant Enterobacteriaceae(CRE)in Peking University Shougang Hospital in the past 5 years.Methods CRE strains clinically isolated from Peking University Shougang Hospital from January,2016 to December,2020 were collected for the study,and related clinical characteristics and drug sensitivity results were analyzed.WHONET 5.6 software was used for data analysis.Results A total of 1,263 CRE strains were detected in our hospital from 2016 to 2020,with a total detection rate of 7.2%,showing an increasing trend yearly.The top three isolates were Klebsiella pneumoniae(86.0%),Escherichia coli(10.6%)and Enterobacter cloacae(2.4%).The largest proportion of specimen was respiratory specimens,accounting for 59.5%,followed by urine specimens and blood specimens,accounting for 19.4%and 13.6%,respectively.The top three Departments in the distribution of CRE strains were Intensive Care Unit(32.6%),Respiratory Care Unit(19.4%)and Pneumology Department(19.0%).The top three detection rates were from Intensive Care Unit(18.1%),Respiratory Care Unit(17.9%)and Emergency Department(15.8%).The majority of CRE-infected patients were 60 years old above,accounting for 93.2%.The average resistance rates of CRE to cephalosporin,penicillin and quinolone were more than 90.0%,and the resistance rates to gentamicin,amikacin and compound sulfamethoxazole were relatively low,according for 81.0%,62.3%and 46.2%,respectively,the resistance rate to colistin was the lowest,about 3.5%.Conclusion CRE infection in our hospital is increasing yearly,and the drug resistance is serious.Active and effective infection prevention and control measures should be taken in clinical practice.
作者
农金轻
张春燕
胡守奎
谷依林
王春梅
NONG Jinqing;ZHANG Chunyan;HU Shoukui;GU Yilin;WANG Chunmei(Department of Clinical Laboratory,Peking University Shougang Hospital,Beijing 100144,China;Department of Emergency,Peking University Shougang Hospital,Beijing 100144,China)
出处
《标记免疫分析与临床》
CAS
2022年第4期584-588,642,共6页
Labeled Immunoassays and Clinical Medicine
关键词
耐碳青霉烯类
肠杆菌科细菌
耐药性
Carbapenem-resistant
Enterobacteriaceae bacteria
Drug resistance
