【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(CRKP268株,CREC42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。更多还原

【Abstract】 Objective To understand the clinical distribution and antimicrobial resistance characteristics of clinically isolated carbapenem-resistant Klebsiella pneumoniae(CRKP)and carbapenem-resistant Escherichia coli(CREC).Methods Clinically isolated Klebsiella pneumoniae and Escherichia coli from a hospital between January2010 and December 2016 were analyzed retrospectively,isolation of CRKP and CREC were conducted statistical analysis.Results From2010 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 from1.33% in 2010 to12.70%in2016,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%from2010 to2016.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).Conclusion During 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.更多还原