【摘要】 目的：了解临床分离的耐碳青霉烯肠杆菌科细菌（CRE）耐药性和分布特点及其携带的整合子和碳青霉烯基因情况。方法：收集2021年1月至2021年12月郑州大学第一附属医院郑东院区住院患者临床分离的非重复CRE共659株，使用VITEK 2-Compact全自动微生物鉴定及药敏分析系统进行细菌鉴定及药敏试验，头孢曲松、头孢呋辛和氨苄西林/舒巴坦药敏试验采用纸片扩散法（K-B法）检测，采用聚合酶链式反应（PCR）检测碳青霉烯基因基因及Ⅰ类整合酶基因。结果：659株CRE主要分布在重症监护室（45.22%）、呼吸重症监护室（13.96%）、急诊重症监护室（9.26%）、泌尿外科（7.74%）、呼吸内科（4.10%），对β–内酰胺类和喹诺酮类抗菌药物耐药率大于90%,blaKPC、blaNDM、blaIMP基因的检出率分别为81.33%、10.93%、0.30%,5株耐碳青霉烯肺炎克雷伯（CRKP）中同时携带blaKPC和blaIMP基因。CRKP、耐碳青霉烯大肠埃希菌（CREC）中Ⅰ类整合酶阳性率分别为90.94%、74.07%。结论：659株CRE中，CRKP分离率较高，耐药基因以blaKPC、blaNDM为主，Ⅰ类整合子检出率较高，应加强院内感染防控措施，有效控制此类菌的播散。更多还原

【Abstract】 Objective To investigate the drug resistance and distribution characteristics of clinically isolated carbapenemresistant Enterobacteriaceae bacteria(CRE), and their carrying integrons and carbapenem genes. Methods A total of 659 nonrepetitive CRE strains were collected from inpatients in Zhengdong Branch of the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2021. The VITEK 2-compact automatic microbial identification and drug sensitivity analysis system was used for bacterial identification and drug sensitivity testing. The susceptibility tests for ceftriaxone, cefuroxime, and ampicillin/sulbactam were performed using the paper diffusion method. Carbapenem genes and class I integrase genes were detected by the polymerase chain reaction(PCR) method. Results 659 strains of CRE were mainly distributed in the intensive care unit(45.22 %),respiratory intensive care unit(13.96 %), emergency intensive care unit(9.26 %), urology department(7.74 %), and respiratory department(4.10 %). The resistance rates to β-lactam drugs and quinolone drugs were more than 90 %. The detection rates of blaKPC,blaNDM, and blaIMP genes were 81.33 %, 10.93 %, and 0.30 %, respectively. 5 strains of carbapenem-resistant Klebsiella pneumoniae(CRKP) carried blaKPC and blaIMP genes at the same time. The positive rates of class I integrase in CRKP and carbapenem resistant Escherichia coli(CREC) coli were 90.94 % and 74.07 %, respectively. Conclusion Among 659 strains of CRE, CRKP has a high isolation rate, the drug-resistant genes are mainly blaKPC and blaNDM, and the detection rate of class I integron is high. The prevention and control measures of nosocomial infection should be strengthened to effectively control the spread of this kind of bacteria.更多还原