2010—2016年耐碳青霉烯类肺炎克雷伯菌及大肠埃希菌临床分布及其耐药特征
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徐红云

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Distribution and antimicrobial resistance of carbapenemresistant Klebsiella pneumoniae and Escherichia coli in 2010-2016
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    摘要:

    目的了解临床分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)及耐碳青霉烯类大肠埃希菌(CREC)的临床分布状况及耐药特征。方法回顾性分析某院2010年1月—2016年12月临床标本分离的肺炎克雷伯菌及大肠埃希菌,统计分析CRKP及CREC分离情况。结果2010—2016年7年共收集临床分离耐碳青霉烯类肠杆菌科细菌(CRE)310株(CRKP 268株,CREC 42株),CRKP检出率由2010年的1.33%上升到2016年的12.70%,呈逐年上升趋势(χ2=123.73,P<0.01);CREC检出率则处于相对稳定状态,2010—2016年均约为1.00%;标本来源和病区分布最多者分别为呼吸道标本(45.49%)和重症监护病房(31.93%)。药敏试验结果显示,CRKP和CREC除对阿米卡星耐药率稍低(分别为 80.60%、 38.10%)外,对大多数临床常用抗菌药物如第三代头孢菌素类、第四代头孢菌素类、β内酰胺类/酶抑制剂类、喹诺酮类等耐药率CRKP均>90%、CREC均在80%左右,而非CRE菌株的耐药率低于CRE菌株(P<0.01)。结论7年间临床分离的CRKP的检出率呈现快速增加的趋势,几乎对常用抗菌药物均耐药,应予以高度关注。

    Abstract:

    ObjectiveTo understand the clinical distribution and antimicrobial resistance characteristics of clinically isolated carbapenemresistant Klebsiella pneumoniae (CRKP) and carbapenemresistant Escherichia coli (CREC). MethodsClinically isolated Klebsiella pneumoniae and Escherichia coli from a hospital between January 2010 and December 2016 were analyzed retrospectively, isolation of CRKP and CREC were conducted statistical analysis. ResultsFrom 2010 to 2016, a total of 310 carbapenemresistant Enterobacteriaceae (CRE) isolates (268 were CRKP strains and 42 were CREC strains) were collected, isolation rate of CRKP increased from 1.33% in 2010 to 12.70% in 2016, showing an increasing trend year by year (χ2=123.73, P< 0.01); isolation rate of CREC was relatively stable, were all about 1.00% from 2010 to 2016. Most specimens were respiratory tract specimens (45.49%) and from intensive care unit (31.93%). Antimicrobial susceptibility testing showed that except resistance rates of CRKP and CREC were slightly lower to amikacin (80.60% and 38.10% respectively),  resistance rates of CRKP to most commonly used antimicrobial agents, such as third generation cephalosporins, fourth generation cephalosporins, βlactamase/lactamase inhibitors, and quinolones were all>90%, resistance rates of CREC to above antimicrobial agents were all about 80%, resistance rate of nonCRE strains was lower than that of CRE strains (P<0.01). ConclusionDuring the past 7 years, detection rate of clinically isolated CRKP increased rapidly, were almost resistant to commonly used antimicrobial agents, which should be paid close attention.

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徐红云, 刘春林, 陈弟,等.2010—2016年耐碳青霉烯类肺炎克雷伯菌及大肠埃希菌临床分布及其耐药特征[J]. 中国感染控制杂志,2018,17(8):688-692. DOI:10.3969/j. issn.1671-9638.2018.08.007.
XU Hongyun, LIU Chunlin, CHEN Di, et al. Distribution and antimicrobial resistance of carbapenemresistant Klebsiella pneumoniae and Escherichia coli in 2010-2016[J]. Chin J Infect Control, 2018,17(8):688-692. DOI:10.3969/j. issn.1671-9638.2018.08.007.

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  • 收稿日期:2017-09-11
  • 最后修改日期:2017-10-29
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  • 在线发布日期: 2018-08-28
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