摘要
目的分析大连市友谊医院近7年的碳青霉烯耐药肠杆菌目细菌(CRE)临床分布和流行病学特征以及耐药性,为临床治疗CRE感染提供理论依据。方法回顾大连市友谊医院2018年—2024年分离的所有肠杆菌目细菌4714株,采用WHONET 5.6和SPSS 26.0软件分析临床分布和耐药性,利用Excle表格对数据进行整理,分析流行病学特征。结果共检出842株CRE,检出率17.86%;主要分布在重症医学科(426株,50.59%),痰标本检出率最多(432株,51.31%),所有CRE检出呈逐年上升趋势,细菌以肺炎克雷伯菌最多(656株,77.91%);感染CRE以老年男性患者为主,80岁以上患者检出488例,冬季检出率最高(21.58%);CRE的耐药率普遍偏高,肺炎克雷伯菌对一、二代头孢菌素类药物和氨苄西林/舒巴坦呈全耐药状态;产气肠杆菌对阿米卡星的耐药率最低(5.9%);CRE对亚胺培南和美罗培南的最低抑菌浓度MIC≥8 mg/L占比大于80%。结论大连市友谊医院近年感染CRE的患者主要为老年男性,以呼吸道感染为主,冬季易发;CRE检出率有逐年增高趋势,监测CRE的耐药情况和分析CRE的流行病学特征,有助于临床治疗CRE感染和采取相应的防控措施。
Objective To analyze the clinical distribution,epidemiological characteristics and drug resistance of Carbapenem resistant Enterobacteriaceae(CRE)in our hospital in the last 7 years,and to provide a theoretical basis for clinical treatment of CRE infection.Methods In our hospital,4714 strains of all bacilli from 2018 to 2024 were examined.Whonet 5.6 and SPSS 26.0 were used to assess the clinical distribution and drug resistance,and Excel was used to sort the data in order to examine the epidemiological features.Results A total of 842 CRE strains were detected with a positive rate of 17.86%,CRE was mainly distributed in the Department of Critical Care Medicine(426 strains,50.59%),and the detection rate of sputum specimens was the highest(432 strains,51.31%),with an increasing trend year by year.Klebsiella pneumoniae was the most common bacteria(656 strains,77.91%).The infection of CRE was mainly in elderly male patients,488 cases were detected in patients over 80 years old,and the detection rate was the highest in winter(21.58%).The drug resistance rate of CRE was generally high.While Enterobacter aerogenes had the lowest rate of resistance to Amikacin(5.9%),Klebsiella pneumoniae is completely resistant to both first and second generation cephalosporins as well as Ampicillin Sulbactam.In over 80%of cases,the MIC of CRE to imipenem and Meropenem was≥8 mg/L.Conclusion Elderly male patients with respiratory tract infections made up the bulk of CRE patients in our hospital in recent years.The number of patients with winter infections is high,and the detection rate of CRE is rising annually.Monitoring the drug resistance of CRE and analyzing the epidemiological characteristics of CRE are helpful for the clinical treatment of CRE infection and corresponding prevention and control measures.
作者
郑远明
李佩璇
周杰
Zheng Yuan-ming;Li Pei-xuan;Zhou Jie(Dalian Friendship Hospital,Dalian 116001)
关键词
肠杆菌目细菌
CRE肺炎克雷伯菌
临床分布
流行病学
耐药性
抗菌药物
Enterobacteriaceae
CRE Klebsiella pneumoniae
vlinical distribution
epidemiological
drug resistance
antibiotics
